By Nancy Faber
November 19, 1984 12:00 PM

For decades aging actors have visited their plastic surgeon for a nip here and a tuck there to keep their careers on course. But the closest most American men came to cosmetic surgery was to repair a broken nose. Now that is changing, according to John Quincy Owsley, a San Francisco plastic surgeon for 23 years. “In the early 1970s men were only 5 percent of my practice, ” he says. “Now it’s closer to 20 percent.” Married and the father of two children from an earlier marriage, Owsley, 56, is a clinical professor of plastic surgery at the University of California at San Francisco and is also in private practice. He discussed the increase in cosmetic surgery for men with correspondent Nancy Faber.

Why do men seek plastic surgery?

For the competitive edge. It’s a youth-oriented society, and the media’s message is: If you’re old, you’re out. A man may be in line for a vice-presidency or a regional manager’s job. He comes in so he can look 45 instead of 55. It’s also well known that older men tend to date younger women. So they come in for surgery because they are trying to compete for the same women as younger men. And these days men are simply more concerned with how they look. They get their hair styled and use bronzing creams and other cosmetics.

How pervasive is cosmetic surgery?

The number of plastic surgeons has more than doubled in the last 15 years, from 1,200 to 2,600. Among women this kind of surgery is almost a status symbol. A lot of my men patients saw their wives or girlfriends having aesthetic surgery and thought that maybe there’s something in it for me.

What kind of men are having this done?

A fair number of doctors—particularly psychiatrists, who realize how body image relates to confidence—lawyers, judges, professors, businessmen and actors. Most of my male patients are heterosexual, even in San Francisco, which has a very large homosexual population.

What type of plastic surgery is most commonly performed on men?

Eyelids, then facelifts and noses. That wattle under the chin bothers many men. For every man having a facelift, I do nine women, whereas I do three male eyelid operations for every seven women.

Have you had your eyelids done?

Yes, about seven years ago. The operation was performed by my associate. I had done his the year before. We practice what we preach.

What happens in eyelid surgery?

You remove the sagging, drooping excess skin above and below the eye, and also the fat. You cut around the excess skin on the upper lid and remove it. The fat beneath the skin is trimmed away, and the lid is brought together and stitched. On the lower lid you make an incision just below the eyelashes, peel the skin back, take out the fat, pull the skin up like a reverse shade, then trim the excess and stitch. Since eyelid surgery lasts 10 years or more, it is unusual to have more than two such operations.

What happens with a facelift?

You tighten the face by removing sagging, excess skin, fat and underlying membrane through incisions, hiding the scars in the hair in back of the ear or behind the cartilage in front of the ear canal. With men the incision along the edge of the beard can be disguised by sideburns until it fades, which takes three to six months.

What is new about this technique?

It tightens the superficial musculoaponeurotic system, the membrane that lies under the skin and fat. Older methods just pulled the skin up. They didn’t touch the fat, muscle or underlying membrane, and tried to correct it by compression. This new technique allows you to get a good tight neck and chin while eliminating the “pulled look” that formerly stigmatized a new facelift. It takes about two weeks for a patient to look normal.

What drugs are used in the operations?

The patient is given intravenous medication—a combination of a narcotic like Demerol and some Valium, which produces a light sleep and has a wide margin of safety, unlike the barbiturates used before that depressed respiration.

How long do operations take?

An eyelid operation takes about an hour and a half to two hours. After the operation the patient recovers for two to three hours. A facelift takes about three hours. To keep subsurface bleeding from developing I like to keep patients sedated in the hospital one night. Eyelid patients can go home but are told to stay in bed for 24 hours.

How much do operations cost?

Fees vary across the country, but in general facelifts range from $2,000 to $5,000, eyelids from $2,000 to $4,000, noses from $1,800 to $3,000 and forehead lifts from $2,000 to $4,000.

What is the best age for a facelift?

When the face is just beginning to show signs of aging. If a facelift is done at 45, it makes the patient look as if he’s in his late 30s. He can go 8 to 10 years before he looks 45 again. Though it’s time then for another facelift, he’s still ahead of the game. Two facelifts per patient are normal, though some have as many as four. After age 70, results are not as good, nor do they last as long.

What counseling do you give patients?

Before surgery we try to educate a patient as to what he can realistically expect the operation to do. We advise him that although he can be back in circulation and will look normal in two to three weeks, the tissues and scars will not completely heal for three to six months.

How should patients deal with inquiries from friends after the operation?

Some men are straightforward; some stonewall. Ideally surgery should be done early enough so that it is not so obvious.

What are common misconceptions about plastic surgery?

A lot of people believe that you can do surgery and not leave a scar. But not leaving a scar means the scar is placed where it doesn’t show. We are not waving a magic wand.

Are men and women more open these days about the operation?

There haven’t been as many men who admit they’ve had plastic surgery. Betty Ford made a big difference for women when she told the public about her facelift. I think John De Lorean is among the first celebrated men whose facelift was discussed. And Michael Jackson has said, yes, he did have his nose done.