Men's Cosmetic Surgery Guide | A Summary of Popular Procedures, Costs, and Downtime for Men

Basic knowledge of men's rhinoplasty and the background of its popularity

Why men's rhinoplasty is increasing now

In recent years, cases of men wishing to undergo cosmetic surgery (especially rhinoplasty) are on an increasing trend worldwide. There is also data reporting that the proportion of men in Asian countries increased from 12% in 2005–2009 to 19% in 2010–2014. Behind this is the fact that, with the spread of social media and the influence of idols, the standard of men's aesthetic awareness has changed greatly. It is thought that the decrease in social prejudice against men undergoing cosmetic surgery is driving the increase in demand. An increasing number of men in their 20s to 30s want to resolve their complex about the nose—located at the center of the face and greatly influencing first impressions—and acquire a crisp, masculine face.

Anatomical differences between male and female noses (bone structure and skin characteristics)

To fundamentally resolve a man's nasal complex, understanding the clear anatomical differences from the female nose is indispensable. Compared with women, the male nose has wider, thicker nasal bones, and the cartilage is also built more robustly. In addition, the biggest cosmetic-surgical difference is the "nature of the skin."The skin of the male nose is markedly thicker than a woman's, and sebaceous glands (organs that secrete sebum) are abundantly present and developed. Furthermore, the distribution of hair such as beard is greater, the amount of sweat secretion is also greater, and the pH value of the skin surface tends to be low.

This "thick, sebum-rich skin" brings a drawback: even if the internal cartilage and bone are precisely adjusted to the millimeter, it becomes like having a thick futon draped over it, and that change is unlikely to appear on the surface as outward sharpness. In addition, compared with women, men have stronger force from the movement of facial muscles, and when laughing and so on, a large force pulling on the nasal tip is exerted. To withstand this force and maintain the height of the nasal tip over a long period, special structural reinforcement is essential.

Representative types of men's rhinoplasty and rough cost guidelines

In men's rhinoplasty, a technique tailored to each individual's bone structure is selected. The representative surgeries, their characteristics, and rough cost guidelines are as follows.

Implant insertion and autologous tissue grafting (augmentation rhinoplasty)

A surgery aimed at improving the height of the nose bridge. Because Asian men tend to have short nasal bones and a low nasal root (the base of the nose), it is often used. The rough cost guideline isaugmentation rhinoplasty 300,000–800,000 yen overall, and 250,000–600,000 yen for the implant alone.

• Medical silicone implant:Easy and relatively cost-controlled, but the artificial material carries risks of infection and exposure through the skin, and caution is needed especially for men, whose skin tends to be under tension.
• Autologous tissue grafting:A method of harvesting one's own ear cartilage or costal cartilage (rib cartilage) and grafting it to the nose. In recent years, techniques using autologous tissue, such as the "DCF method (Diced Cartilage wrapped in Fascia)," in which one's own cartilage is finely diced and wrapped in fascia, are attracting attention as a global trend from the standpoint of safety. Because harvesting and precise processing require advanced skill, the cost becomes high.

Three approaches to nasal tip plasty (improving a bulbous nose)

A surgery to refine the nasal tip to be thin and sharp, with a rough cost guideline of 300,000–600,000 yen. A man's "bulbous nose" is formed by the complex interplay of three anatomical causes: (1) excessive bulging or spreading of the alar cartilage (the cartilage that forms the nasal tip), (2) markedly thick skin and developed sebaceous glands, and (3) thick subcutaneous fat and connective tissue.

To resolve a man's bulbous nose, which has thick skin and strong cartilage, the "nasal tip plasty" procedure that reconstructs the cartilage structure itself is indispensable, and the following three full-fledged approaches are mainstream.

• Suture method (interdomal suture, transdomal suture, etc.):A technique that draws together the splayed cartilage with a dedicated medical thread to make it sharp. The transdomal suture narrows the dome-shaped cartilage of the nasal tip, and the interdomal suture brings the left and right separated cartilages together at the center.
• Columellar strut (cartilage pillar):By sandwiching a cartilage pillar between the left and right cartilages, it powerfully supports the nasal tip. There are a "floating type" placed in front of the bone and a "fixed type" fixed to the bone, and it is indispensable as building a firm foundation to lift the heavy, thick skin of men.
• Cartilage grafting (tip graft):When suturing alone is insufficient, cartilage is harvested from the ear or nasal septum and grafted to the optimal position on the nasal tip. This creates a clear definition of the nasal tip even from over thick skin.

Septal extension and alar reduction (nostril reduction)

• Septal extension:A surgery that extends a short nose or an upturned nasal tip downward or forward. Asian men often have a short nasal septum, so cartilage from the ear or rib is grafted on to powerfully push the nasal tip forward. Because a powerful foundation is needed to lift the thick skin of men and prevent future deformity, it requires advanced skill, and the cost tends to be high, at 500,000–1,000,000 yen.
• Alar reduction (nostril reduction):A surgery that suppresses the flaring of the nostrils, with a rough cost guideline of 200,000–400,000 yen. The tissue at the boundary between the ala and the cheek is excised in a wedge shape (V-shape). In the case of men, performing excessive excision loses masculinity and becomes unnatural, so a conservative design that stops at a slightly insufficient degree is required.

The limits of "non-cutting treatment (mini cosmetic procedures)"

Out of fear of surgery or concern about downtime, not a few men wish for non-cutting treatments (mini cosmetic procedures) such as "just tying with thread" or "just an injection." However, because the male nose is composed of "thick, heavy skin" and "robust cartilage," thread or drugs alone cannot overcome the resistance of this firm tissue, andin the majority of cases it quickly reverts to its original shape, or almost no change can be felt. For fundamental resolution of the complex, a surgical approach is the overwhelming standard.

Don't become unnatural! Three iron rules for a natural result

What is most to be avoided in men's rhinoplasty is becoming an "artificial, unnatural nose (a feminine nose)" that obviously looks operated on. Applying a technique aimed at women directly and making it excessively thin or too small will make it stand out from the balance of the whole face and rob the male face of masculinity. To achieve naturalness as well, there are the following three iron rules.

Iron rule 1: A "straight line" is the correct answer for a man's nose bridge

When viewed from the side, drawing a powerful, straight line that extends straight from the nasal root to the nasal tip is the ideal shape for men. The kind of "slope" that gently curves toward the nasal tip, preferred in women's noses, or the slight depression above the nasal tip (an upturned nose), is not suitable for men and tends to be perceived as a feminine feature.

Iron rule 2: A nasolabial angle of 90–95 degrees is the golden zone

Setting the nasolabial angle (the angle formed by the base of the nose and the upper lip) is also important. The ideal for women is a slightly upward 95–105 degrees, but statistical data report thatthe nasolabial angle that looks most beautiful and natural for men is roughly 90 degrees, or in the range of 90–95 degrees. If a man makes the angle too large, the nostrils tend to become conspicuous and give an unnatural impression.

Iron rule 3: A "conservative approach" that preserves tissue

In recent years, as a global trend, the "Preservation Rhinoplasty" approach—which, rather than excising tissue greatly, makes maximum use of and preserves the original tissue while shaping it—is attracting attention. By using techniques that lower the position of the original roof part of the nose (the nasal dorsum) without destroying it, one can aim for a natural nose bridge that feels innate, without any sense of surgical traces.

Cost ranges and the risk of choosing on "price" alone

Three factors that determine the cost of rhinoplasty

Rhinoplasty fees range widely, from several hundred thousand yen to over a million yen. The reason is that they vary according to the following three factors.

1. The difficulty and type of the technique (approach method):The difficulty and time change depending on whether it is the closed method, incising only inside the nasal cavity, or the open method, incising the columella as well.
2. The materials used:The cost differs depending on whether a silicone implant or autologous tissue requiring advanced skill (ear cartilage or costal cartilage) is used.
3. The combination of procedures:If a combined surgery is performed—such as shaving down a hump while raising the nasal tip and creating a defined bridge—the total cost is added up.

Furthermore, the male-specific excision of a robust, large bone structure (osteotomy, etc.) and the building of a powerful foundation to lift thick skin require more advanced skill than women's surgery, so the technical fee tends to be reflected in the cost.

Choosing on "cheapness" alone invites the enormous cost of revision surgery

Choosing a clinic based on price alone, drawn to "bargain" or "monitor price" offers, is very dangerous. There is data that male cosmetic surgery patients have a high degree of dissatisfaction with their preoperative appearance and tend to have low postoperative satisfaction (in one survey, 87.6% for women versus 56.1% for men). One reason for this is that the physician performed the surgery with the same sense as for women, without understanding the male-specific bone structure.

The inside of a nose that has been operated on once has hardened tissue and adhesions (tissues that are not originally connected sticking together strongly), and the difficulty of the surgery jumps to several times that of the first time. Therefore,the cost of revision surgery at another clinic generally becomes 1.5 to over 2 times that of the first surgery. The risk of incurring an unexpected expense on the scale of millions of yen and great psychological damage by pursuing cheapness should be avoided.

Cost-effectiveness as a lifelong self-investment

Hyaluronic acid injections and the like revert over time, but full-fledged rhinoplasty that reconstructs the bone and cartilage structure itself is, once completed, literally a "lifelong" effect. It brings great psychological benefits such as improved self-affirmation and the resolution of anxiety. Entrusting it at an appropriate price to a specialist well versed in the characteristics of men, and"reliably completing the ideal shape with a high-quality first surgery," produces the greatest cost performance.

Tricks to avoid being noticed by those around you and how to spend the downtime

The causes of rhinoplasty being noticed and techniques that are hard to notice

There are three causes of rhinoplasty being noticed by those around you: "excessive change," "an unnatural result (feminization, etc.)," and "being witnessed in the appearance change during downtime." If you prioritize being hard to notice above all, the "closed method (intranasal incision)" is advantageous as a surgical approach. Because all incisions are made inside the nostrils, no scar remains on the outside at all. On the other hand, the "open method (columellar incision)" has a wide operative field and is suited to complex revisions, but a small incision is added to the columella (it becomes inconspicuous in a few months).

A day-by-day timeline of downtime and a guideline for returning to work

Because the thick skin of men takes time to adhere closely to the new bone framework, swelling and edema tend to linger longer than in women.

• Postoperative days 1–3 (peak of swelling and internal bleeding):The inflammatory reaction is strongest and pain is also involved. Swelling and internal bleeding may spread to the area around the eyes and cheeks. Refraining from going out is recommended.
• Postoperative days 5–7:The cast (splint) is removed and the stitches are taken out at the clinic. In the case of desk work or remote work, returning to work at this timing (about one week postoperatively) is a general guideline. Wearing a mask makes it less likely to give a sense of discomfort.
• Postoperative 2 weeks–1 month:The conspicuous internal bleeding is absorbed and reaches a level with almost no hindrance to daily life. In the case of occupations where blood pressure and heart rate rise, such as manual labor or sales, about 2 to 3 weeks of rest postoperatively or reassignment to light work is recommended.
• Postoperative several months–up to one year:The fine swelling also settles, and it becomes the final completed form. For men, it can take up to nearly a year for the tissue to settle completely.

Care to make swelling subside faster and NG behaviors

[Recommended care methods]

• Acute-phase cooling and elevation of the head:Until postoperative day 2, frequently cool the area around the affected site with an ice pack, and when sleeping, support edema reduction by stacking pillows to keep the head high.
• Taping therapy:Even after the cast is removed, continue fixation with medical tape for about 2 weeks postoperatively to suppress edema and make the skin adhere to the cartilage.
• Appropriate skin care:Because the amount of sebum secretion increases after surgery, neglecting face washing and moisturizing causes acne and clogged pores.
• TAI injection (triamcinolone injection):Men have many sebaceous glands, and if "supratip edema (a state where the area above the nasal tip swells)" lingers, it causes fibrosis, and there is a risk of inducing a "polly beak deformity" in which the nasal tip becomes round and raised. For intractable swelling, a steroid injection (Kenacort/TAI injection) that lowers vascular permeability and prevents fibrosis is an effective solution.

[NG behaviors to avoid]

• Vigorous exercise that raises the heart rate, saunas, long baths, alcohol intake (restricted for 3 weeks postoperatively).
• Physical stimulation such as touching, rubbing, or blowing the nose hard (risk of cartilage displacement or deformity).

Camouflage techniques during downtime

To deceive the eyes of those around you, the following are effective means: utilizing a mask after the cast is removed, using glasses or sunglasses to hide internal bleeding around the eyes (be careful not to rest them directly on the nose for 2 to 3 weeks postoperatively), utilizing long holidays such as Golden Week or the New Year, and utilizing remote work. In addition, not changing greatly all at once and stopping at a conservative design is the greatest camouflage.

Don't fail! Six rules for choosing a recommended clinic

Men's rhinoplasty requires a specialized approach entirely different from women's rhinoplasty. "Being good at women's rhinoplasty = also being good at men's rhinoplasty" does not necessarily hold. To reduce the risk of failure, it is important to discern the clinic and physician according to the following rules.

1. Expertise that understands the differences in bone structure and skin between men and women

Choosing a specialist who is well versed in the male-specific thick skin and the aesthetics of a straight nose bridge and has abundant experience operating on male patients is an absolute requirement.

2. The "five questions" to confirm in the consultation

Because men tend to be poor at putting their desired design into words, you should choose a physician skilled in "listening ability." In the consultation, be sure to confirm the following.

1. Will they show you a computer simulation (visualization of the postoperative image)?
2. Where are the risks and limits given my "skin thickness" and "bone structure"? (Do they honestly tell you "it can't be done" for things that can't be done?)
3. Is the balance with not just the nose but the whole face achieved?
4. Is improvement of the functional aspect (nasal congestion, etc.), not just the cosmetic purpose, also considered?
5. Will the postoperative design become too "feminine" due to excessive thinness or curve?

3. The correct way to view "male case photos" and long-term stability

You must not judge by beautiful female case photos alone. Be sure to check "male case photos." There is a risk that the nasal tip drops in the months to years after surgery, unable to withstand the strong facial muscles and the weight of the thick skin of men. Pay attention to "whether the nose bridge curves too much like a woman's" and "whether the height of the nasal tip is maintained in photos taken months to years later (whether a firm foundation has been built)."

4. The proposal capability for advanced techniques

Choose a clinic that, not just inserting a silicone implant, accurately analyzes your bone structure and skin thickness and logically designs and proposes "why that technique is needed" from a multifaceted perspective, including approaches using "autologous tissue (costal cartilage or the DCF method)" as needed.

5. A well-developed aftercare system

Whether a well-developed aftercare system that promptly handles medical measures such as taping guidance and Kenacort injection (TAI injection)—against the swelling and fibrosis risk that tends to linger in men—is in place will determine the final beauty.

If you have any concerns, please feel free to consult a specialized clinic that conducts consultations based on medical evidence first.

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