Cuts both ways

More and more men in the Middle East are undergoing cosmetic surgery. Georgia Lewis reports on the trends and why it’s OK for guys, as well as girls, to submit to the scalpel in the name of vanity.

February 2008

The sight of post-nose job women is not unusual in the Middle East. It can be somewhat startling for a newcomer to the region to see so many publicly bandaged noses and then wonder if the ladies here have an unusually high propensity for pub brawls.

Here, it’s perfectly acceptable for women to ‘fess up’ to everything from a Nancy Ajram nose job to perky Pamela Anderson implants. And after having a baby, it just makes good aesthetic sense to go in for a tummy tuck, spot of lipo and a boob lift to get the chest puppies back to their former glory.

Bur what of the blokes? While for many men, a grooming routine consists of using the same cake of soap for a shower, shave and shampoo, for others, it can be a much more involved process. Much, much more.

The rise of the metrosexual meant guys like David Beckham replaced the likes of Steve McQueen in setting the standard for how a man should look. Suddenly, blokes’ bathroom cabinets the world over became as full as their wives’ and girlfriends’ stashes of beautifying lotions and potions.

It’s now OK to go in for ‘product’ for the hair, aftershave, aftershave balm, moisturiser, exfoliant, cleanser, toner, chest wax, the male spas that have opened up all over town… Many a traditional man, armed only with a cake of Lifebuoy and a rusted bottle of Old Spice, wondered where the hell it was all going to end.

Well, it looks like the operating theatre is the final frontier for male vanity. Statistics show that the number of men undergoing cosmetic surgery is on the rise across the nationalities. In the UAE, there has been a 100 per cent surge since 2005 in men seeking aesthetic procedures with 5,000 men a year submitting to the scalpel, according to figures supplied by Dubai surgeon Dr Toledo.

Among this 5,000-strong (and growing) army of surgical stud-muffins, the most popular procedures include nose jobs, hair transplants, liposuction and gynaecomastia (liposuction of the chest to eliminate the dreaded man boobs).

Why are men going under the knife?

So why don’t these blokes just accept the noses nature gave them or go to the gym and eat fewer pies to rid themselves of unwanted flab? According to Dr Toledo, the patients generally aren’t lazy slobs wanting a quick fix. These are guys who have worked hard with exercise and a healthy diet but have not yet achieved their ultimate body because of accursed genetics. In short, they want to look as good as they feel.

“There are limits to what men can achieve through exercise depending on their body type and bone structure,” says Dr Toledo. “The result from aesthetic surgery is then the reward for all that hard work they have put in with their exercise and diet regime.”

Not surprisingly, the rise in affluence across the Middle East has made cosmetic surgery more affordable to more people. The endless cavalcade of cosmetic surgery clinics along Dubai’s Jumeirah Beach Road and Beirut’s Hamra district are testament to the extra money people are prepared to spend on self-improvement.

“Men are more conscious now, they have more disposable income, especially young men, and opting for an aesthetic procedure is not looked down upon anymore,” says Dr Toledo.

Who is going under the knife?

Men of all ages and all nationalities in the Middle East are opting for cosmetic surgery, according to Dr Toledo. Indeed, in his Dubai-based practice, nearly half his patients are UAE nationals. The gender split is 80 per cent women/20 per cent men in the UAE, compared with an 88 per cent/12 per cent split in Brazil, where Dr Toledo formerly worked. Across the age groups, there are procedures that are more popular with different generations of men.

Gynaecomasty – the reduction of male breasts – is popular for late adolescent men who haven’t quite outgrown chest puppy fat and then there is another surge in the popularity of this operation for men aged 60 and over, a time when the male anatomy does tend to head south. Among very young children – generally before they go to school – pinning back ears is a common procedure to prevent playground cruelty.

Nose reshaping is not recommended until a man stops growing and the bones have stabilised. After the age of 35, men then go in for rejuvenation procedures such as facelifts and eyelid surgery and liposuction is popular across the entire spectrum of ages.

What about the patient’s mental health?

Dr Toledo says that being able to assess a potential patient’s mental fitness for surgery is an important part of any cosmetic surgeon’s training. One of the most vital aspects to be assessed by a surgeon is whether a patient, male or female, has realistic expectations for the surgery. In fact, Dr Toledo has refused to perform surgery on patients because they have unrealistic expectations and he knows they will never be happy with whatever work is done.

“Just removing the physical problem won’t always cure other things,” warns Dr Toledo. “The questions that we use to avoid red flag patients is to ask who are you doing this for? If they’re doing it for themselves, that’s always a good option. If they’re doing it for someone else – because my wife asked me to - then you’ll never like it.”

Dr Toledo tells the disturbing anecdote of a male patient who requested a nose job. But when he showed the patient, via computer imaging, what sort of results he could safely and sensibly achieve, the patient kept asking for the nose to be made smaller and smaller. Despite Dr Toledo advising that the small nose would look ridiculous, the patient would not be deterred. Dr Toledo refused him the surgery.

There is an unfortunate postscript to this cautonary tale: “I found out that a year later that he had gone to another surgeon who did what he wanted to do and he was still not happy,” says Dr Toledo. “This happens a lot. They will find somebody who will do it for them but they are still not going to be happy.”

The risks and going too far.

It is important for anyone contemplating cosmetic surgery to be aware of the risks and implications. Like any surgical procedure, there is always a risk involved when going under a general anaesthetic, it is essential to allow for an adequate recovery period and there are biological factors that cannot be controlled by the surgeon. Scarring is almost unavoidable with most procedures and it is impossible to tell how fast a scar will heal or fade, or whether a patient will suffer keloid scarring (scarring that is thick and raised up from the surface of the skin).

Dr Toledo also warns against patients getting sucked in – literally and metaphorically – by a radical procedure known as mega-liposuction, whereby as much as 30 litres of fat can be removed during a single operation. The procedure involves a very long recovery time and Dr Toledo is convinced that it is not safe. “It is very dangerous because you’re not removing only fat, you’re removing serums, proteins and blood as well.”

It might seem like a dream quick fix for anyone wanting to get rid of large quantities of fat but Dr Toledo says the same results can be achieved using a safer, gradual approach of having multiple smaller procedures performed over a period of six to 12 months. Liposuction is generally a better procedure for removing small portions of localised fat rather than using it as a weight loss solution. If you are overweight overall, any good cosmetic surgeon will advise you to try diet and exercise before contemplating an operation.

“Liposuction is a quick fix if you have a small problem,” says Dr Toledo. “The limit should be five per cent of the bodyweight in one procedure, that’s the limit you can remove in one procedure safely.”

Getting into celebrity skin.

Wanting to look like a celebrity is not the wisest reason to undergo cosmetic surgery. This is a desire more common to female patients rather than men, says Dr Toledo.

“What I find in the Arab world is that men don’t want to erase their ethnicity,” he says. “If there’s a hump, they want to remove a little bit of the hump or refine the tip a little bit so it doesn’t hide the lip when they smile - they want to look normal, which is one of the great reasons for plastic surgery.”

Even so, starstruck men will still walk through Dr Toledo’s door. When asked what celebrity most men ask to look like, rather unsurprisingly he says “George Clooney” without a moment’s hesitation. Brad Pitt comes a close second and among Arab men, Shaikh Mohammad Bin Rashid Al Maktoum, Ruler of Dubai, is the man with the most-wanted features. It’s not a matter of being starstruck but more about respect and aspiration.

“Shaikh Mohammad is a great inspiration to many men here,” says Dr Toledo.

But it’s important to assess whether a patient is using a celebrity picture for inspiration or whether they are hoping that surgery will give them that celebrity’s image. “You have people who will come with pictures of people in magazines and they say ‘I want to look like that’. But I will tell them that for a week I want them to find five noses that look like what they want and bring them to me,” says Dr Toledo. “If after a week they come back and bring five noses from different people then I know they are looking for the style of the nose. But if they bring in five pictures of the same person, I know that they want to be somebody else. You know it’s not going to be good because it’s for the image.”

Still keen to go under the knife in the name of self-improvement? Dr Toledo advises patients to search for a surgeon who is a certified member of a plastic surgery association. After all, you want to be confident that the doctor has undergone strict training as a reconstructive and aesthetic surgeon. Twenty per cent of Dr Toledo’s work is fixing up the bad work of other surgeons so choose your surgeon very carefully before you even contemplate going in for the operating theatre rather than the day spa.

• Dr Luiz Toledo, International Modern Hospital Dubai. Tel: +971 4 3988888