These days, it’s not just women who are opting for a nip or tuck. In the past five years, the number of men turning to cosmetic surgery has risen by more than 300%, according to the British Association of Aesthetic Plastic Surgeons (BAAPS).

Figures for men using Botox are even more startling – Patrick Bowler, the medical director of Court House Clinics, says that one in 10 of his Botox clients are now male. And, thanks to the arrival of Dysport, the male Botox injection, these numbers are set to increase again. Dysport does away with the spookily surprised look that isn’t quite so fetching on blokes, giving a heavier, Gordon Brown-style brow instead.

Other popular procedures include nose jobs (rhinoplasty), liposuction, eyelid surgery (blepharoplasty), ear correction (otoplasty), facelifts and neck-lifts. In fact, the surgery-lite business is booming. At Court House Clinics, procedures for men, such as silicone calf implants, are given equal billing with those for women. Bowler says: “Tattoo removal, hair restoration, laser hair removal and glycolic skin peels are top of the popularity chart.”

Last year, there was a 60% increase in tummy tucks for men, largely as a result of weight-loss surgery that sheds the stones and leaves behind excess skin.

It’s hard to imagine John Wayne or Jack Nicholson toying with the idea of a spot of lipo and yearning wistfully for a baby-smooth forehead. So, why are so many men resorting to the scalpel – including, it is rumoured, George Clooney, who made reference to having an eye-lift last year?

Rajiv Grover, a consultant plastic surgeon and member of the BAAPS council, attributes the trend to a culture of “facial discrimination”. “Not only are men, especially those in high-powered jobs, expected to be eternally youthful in terms of stamina and dynamism, but they are increasingly judged on their looks,” he says. Also, men are realising that problems they thought they were stuck with, such as gynaecomastia [man boobs], are actually treatable.”

The surgeon Donato Zizi, who works at the Court House Clinic in London and specialises in hair transplants, puts it more bluntly. “Men are vain, and they are becoming much less self-conscious about procedures,” he says.

So, what kind of man has cosmetic surgery? London surgeon Alex Karidis notes that many of his clients are perfectionists. “One guy, an architect, turned up with blueprints for his new nose,” he says. “Full-scale drawings, done from different angles and planned to the last millimetre. That made me pretty apprehensive – surgery simply isn’t that accurate. But it was okay in the end.”

Karidis’s experience is not unusual. “Men tend to be less stoical and complain more than women,” says Grover. “Men are often more anxious, too, so that might make them more susceptible to pain. They often want more pain relief.”

Karidis recalls: “I had a couple who both came in for liposuction. The next day, she was up and about, but he was still lying there and really struggling. That’s not unusual. Some men are a bit wussy: they have ‘man recovery’, in the same way they have ‘man flu’.” Some men scar more easily, too. “Men have thicker skin,” says Grover. “If it is thinner, you get a finer scar. With facial surgery, the key difficulty is deciding where to hide the scars without hair and make-up to cover them.”

Grover sees another problem. “I am cautious about treating men for facial rejuvenation,” he says. “In the wrong hands, there is a risk of feminising the face. For example, to support the lower eyelid during a facelift on a woman, you might raise the outer corner slightly. This looks attractive, as it creates a nice almond shape, but it wouldn’t look good on a man.”

Most surgeons agree that facelifts are harder to do on men. They have a higher incidence of bleeding due to the thickness of the skin and the fact that men are more likely to have high blood pressure than women. They also have a higher infection rate and more swelling.

When it comes to liposuction, men opt to have it on the waist, abdomen and chest, which can cost from £3,000 to £6,000. The procedure doesn’t work for beer bellies, as they are caused by fat underlying the muscle, but it does work for man boobs, something that more than 30% of men have. Treatment involves liposuction to remove excess fat, and then removing the gland under the nipple. It costs about £4,000, and the patient can be back on his feet in a few days.

So, what’s the future? With an ageing, youth-obsessed culture, most surgeons expect to see more men coming in for surgery, and less furtiveness about booking a fortnight off work to have a spot of lipo or a facelift. And given the male propensity to boast about just about anything, a new nose or a brow-lift could soon rival the MacBook Air in the status stakes.

NEW AND IMPROVED?

A manly brow

Dr Nick Lowe is a specialist in Dysport, a form of botulinum toxin different from Botox. According to Lowe, Botox treatment “can look bizarre and feminine on men”. Studies show that ovulating women often have a strong preference for “a low pupil-to-brow ratio”, which means they find the stern, glowering brows of Gordons Ramsay and Brown more sexually alluring than Graham Norton-style raised eyebrows.

The pec injection

Macrolane, a new type of long-lasting filler, makes it possible to have bigger pecs and manlier calves without surgery. Christopher Inglefield, a consultant surgeon at London Bridge Plastic Surgery, is leading clinical research into Macrolane in the UK. “I can make small changes to body shape that make a big difference to my patients,” he says. The procedure, which takes place under local anaesthetic and has no downtime, involves inserting a cannula tube to push the Macrolane into the right part of the body. It lasts for up to two years and costs about £1,500 for the first treatment, and less for subsequent top-ups.

A bigger nose

A larger nose is an option for men cursed with a cute little button. The method, created by the reconstructive surgeon Martin H Kelly, involves placing a “self-expander”, which looks like a thick contact lens, under the skin at the tip of the nose for two weeks. This gradually swells up, allowing the patient to grow extra skin. Combined with another operation, it enables the nose to be lengthened by “two or three times” more than what used to be possible.

For a list of fully qualified surgeons, visit www.baaps.org.uk

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