Over time we’ve spoken to numerous doctors and gathered a lot of information about cosmetic surgery and hair replacement. To give the mature man an idea of his options we took our notes and spoke with two of the best surgeons in this field to put it all together.
Alvin Glasgold, M.D., and Mark Glasgold, M.D., are a father-and-son team who head up the Glasgold Group for
Mastic Surgery. Between them they cover just about every facet of cosmetic surgery, including lasers, endoscopic surgery, facelifts, and hair flaps and transplants. There’s even a skin care facility on premises.
We wanted to learn about the healthiest way to approach the surgery issue – and a little of the psychology behind it – so any man could begin learning about whatever aspect of cosmetic surgery or hair replacement might interest him.
Perhaps the highest hurdle we must clear when it comes to discussing cosmetic surgery is its perception. A great part of the problem lies with both the doctors who practice it and the media. Both have, perhaps inadvertently, propagated the idea that cosmetic surgery is for women. Both normally use feminine pronouns or mention women when discussing potential patients and, when describing procedures, inevitably stress the benefits of most interest to them. If an individual is preparing for a tonsillectomy or even brain surgery, it doesn’t matter how the process is explained as long as the information is accurate. When it comes to cosmetic surgery, however, there’s a big difference between what what women expect and what men want and ultimately hope to accomplish.
As politically correct as it may be, we’ve concluded that, for women, cosmetic surgery is usually a more comprehensive, dramatic and expectant procedure than it is for men. Women want to look beautiful, yet men don’t necessarily need to be handsome. Women hope to turn back the clock, to look younger, while men are concerned with just looking good at whatever age they happen to be.
Men are not concerned with wrinkles. In fact, lines can make the face stronger and more masculine. But looking perpetually tired is unacceptable. Men start considering cosmetic surgery if the skin above their eyes is drooping, there are bags under the eyes, or their jowls and neck are starting to sag.
Since procedures change constantly and individual doctors often have their own methods, it’s almost impossible to describe the definitive means by which any operation might be done. We will, however, give you an outline of each procedure in its simplest form.
Upper eyelid surgery is a popular option. The fold of skin that hangs over and hides the upper lid can be removed with an incision that falls in the depth of the upper eyelid crease, leaving the eyelid more visible. If the upper eyelid is sagging due to heaviness of the brow area, it can be elevated. The newest procedure for brow elevation is called an endoscopic brow lift. In this operation a few small incisions are made above the hairline and, operating through a thin tube, the surgeon elevates the eyebrow. Obviously, a totally bald man is not a good candidate for this procedure unless he’s willing to accept a scar on his mid-forehead.
Men don’t have a problem discussing hair loss and possible solutions to this condition; this is one area that belongs to them alone. The condition is called male pattern baldness (androgenetic alopecia) and it affects as many as 30 million American men. Its signs are familiar: Receding hairline, thinning on the crown. To treat it, you can get a hairpiece or a wig, have a flap procedure or undergo a hair transplant, which can include both hair grafts and scalp reduction… or invest in a hat collection.
Wigs and hairpieces are available in a variety of forms and can cost anywhere from a few hundred dollars into the thousands. The basic and least expensive method of covering a barren scalp is with a stretch wig. Equipped with an elastic band at the base and worn much like a shower cap, these devices offer full cover-age but rarely look real. Hairpieces and wigs can also be attached by the use of barrets, which clip onto the individual’s hair. (This is useful when the area to be concealed is a small bald spot on the top of the head.) Other methods include bonding, where a hairpiece is glued to the head; weaving, in which a candidate’s own remaining hair is braided and sewn to a metal clip to which the hair piece is then attached; velcro, where a strip of material topped with velcro is attached to the head (the bottom of the hairpiece is also equipped with velcro and the two pieces grip together). A variation of the same concept replaces the velcro with snaps, so a guy can “snap on his hair”. In yet another method, metal cylinders are inserted into the scalp to which hair pieces or individual hairs are connected.
Traditionally, the difficulty with hairpieces is that, if they’re too well connected, the patient can run the risk of problems with keeping the scalp clean and free from infection. If they’re not well connected, they can slip around, making a guy’s hair rather skittish.
Surgical solutions include the flap procedure, a surgery done under general anesthesia in which a 1-1.5 inch section of hair from the side of the scalp (where some hair usually remains) is rotated, while still connected to the scalp at one end, and placed on the front of the head, thus putting a strip of hair directly across the front of the scalp. The benefits of this procedure are that the patient has hair immediately. This hair also grows quickly and is usually thick. One of the less desirable results is that the hair, due to the direction of the rotation, will grow backwards. Also, unless the procedure is done carefully, it can result in a peculiar hairline
Hair flaps work best on individuals who have limited areas of thinning or baldness. If the hair is full in the back and thin in front, a flap can be useful. If the hair on the crown is also thin, however, the flap can appear as an “island” of hair and transplants will be required for balance.
The basic concept of transplants hasn’t changed since the procedure was introduced in the late 1930s. This process takes hair from an area where it is (usually the back and sides of the head) and places it where it isn’t (usually the front and top). Hair transplants were created as a process by which Asian women could increase the size of their eye-brows. In the 1950s doctors began doing this on men.
The means, methods and artistry of hair transplants have come a long way from the original insertions of large, widely spaced plugs into small incisions (to give them greater staying power), which rarely resulted in a natural appearance. In the modern transplant, the hair is no longer clumped tightly into the head. Today’s plugs, which are ordinarily mode up of 10-12 hairs, are usually reserved for the back of a man’s head, while the front is most often treated with mini-grafts (4-6 hairs), micrografts(2-3), or even single-hair grafts, which are becoming popular. Transplant technicians feel the smaller grafts provide greater control and can be placed so as to achieve the most natural look. They also heal more quickly because the incision is less intrusive.
You can be charged for hair transplants by the session, at about S2000-10,000, for 200-800 grafts. It is also possible to be charged per graft. The number of grafts done during a session varies with the individual practitioner, ranging from 100-800 single-strand grafts. The prices can range from S20-30 per graft, and less for single-hair grafts (but, of course, you need more of them).
Before jumping head-first into a transplant, realize that it is not likely that any doctor can give you the full, luxurious hair you see on Baywatch. To begin with, if grafts are put too dose together in an effort to achieve mass and fullness, they can clump. Consequently, the grafts have to be slightly separated, which means that, although it’s possible to give the impression that the head is “covered” with hair, it won’t have a luxurious feeling. Another problem with achieving big hair is that it takes about six months for the scalp to heal completely and the grafts to settle. If a man requires two sessions, he’s already invested a year in this project and is getting tired of the whole thing.