title: The Modern Male Rhytidectomy: Lessons Learned.
abstract: BACKGROUND
  Cosmetic surgery among male patients has become increasingly popular. The face-lift technique is different in male patients, specifically regarding preservation of hair follicles, restoration of a youthful and well appearance, and reduction of the risk of hematoma.
  
  
  METHODS
  A retrospective review of a single surgeon's past 20 years of consecutive male rhytidectomies revealed a cohort of 83 patients. A control group was created by random selection of 83 age-matched female rhytidectomy patients during the same period. Data were collected and analyzed critically for factors contributing to complications, including hematoma, seroma, skin sloughing, alopecia, infection, and nerve injury. The evolution in the senior author's technique in male rhytidectomy is described.
  
  
  RESULTS
  Differences in facial analysis and rhytidectomy technique in male patients and female patients are highlighted. Five male patients (6.0 percent) and no female patients in the control group developed postoperative hematoma (p = 0.0587). No other complications occurred.
  
  
  CONCLUSIONS
  Respecting the patterns of hair growth in incision design, avoiding damage to follicles during dissection, and exercising standard of care (especially avoidance of hypotensive anesthesia) in prevention of postoperative hematoma have delivered safe and consistently reproducible aesthetic outcomes and acceptable complication rates.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Dallas, Texas; Boston, Mass.; and Coconut Grove, Fla.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Division of Plastic Surgery, Department of Surgery, Boston Medical Center; and private practice.
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
authors.affiliation: Dallas, Texas; Boston, Mass.; and Coconut Grove, Fla.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Division of Plastic Surgery, Department of Surgery, Boston Medical Center; and private practice.
authors.forename: James M
authors.initials: JM
authors.lastname: Stuzin
authors.affiliation: Dallas, Texas; Boston, Mass.; and Coconut Grove, Fla.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Division of Plastic Surgery, Department of Surgery, Boston Medical Center; and private practice.
authors.forename: Smita
authors.initials: S
authors.lastname: Ramanadham
authors.affiliation: Dallas, Texas; Boston, Mass.; and Coconut Grove, Fla.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Division of Plastic Surgery, Department of Surgery, Boston Medical Center; and private practice.
authors.forename: Christopher
authors.initials: C
authors.lastname: Costa
authors.affiliation: Dallas, Texas; Boston, Mass.; and Coconut Grove, Fla.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Division of Plastic Surgery, Department of Surgery, Boston Medical Center; and private practice.
authors.forename: Phillip B
authors.initials: PB
authors.lastname: Dauwe
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods*