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It shouldn’t come as a surprise that interest in cosmetic treatments, both surgical and non-surgical, is surging, largely because we’re part of that movement. I’m a board-certified plastic surgeon, and you’re reading this on my blog. But I’ve also cited lots of other sources in recent posts who’ve reported the same news. And here’s another: One in three Americans is considering undergoing a cosmetic treatment sometime over the next year, according to a recent report from RealSelf, the online cosmetic treatment marketplace.

What struck me even more was that nearly half (43%) said they’re motivated by a desire to improve their self-esteem and confidence. And 26% said their desire stemmed specifically from “wanting to appear youthful at work” or “looking for or starting a new job.”

Woke as we’re becoming as a society, ageism in the workplace remains a prevalent concern. And not just for women. In a recent post, I highlighted a number of procedures that are on the rise among early-middle-age men as a means for them to remain relevant in their work. Within the next year, millennials will comprise half the workforce in the United States, according to the US Bureau of Labor Statistics. And in another 10 years, it’ll be up to 75%.

Suddenly in the minority, it’s only natural that those who aren’t millennials could feel that much more vulnerable.

‘It’s really about restoring confidence’

Nancy DellaRocco, 54, an executive for Harvard Business School, is someone who spends a lot of time in front of people, public- speaking and pitching executives. But her confidence began eroding in her thirties, when she started losing her hair. In time, she started to think that people were too distracted by her receding hairline to truly hear anything she was saying.

“You’re used to seeing men with male-pattern baldness, but there’s such a stigma when you’re a woman,” she told the financial news site, Moneyish. “I was going to meetings and leading presentations—and I needed my hair! It sounds like a vanity thing, but it’s really about restoring confidence.”

Following a hair transplant, DellaRocco’s self-esteem rebounded in abundance. “I’m running 120 programs a year with over 11,000 executives from around the world, and doing media online, and I’m feeling really good about myself and my job.”

Attractiveness matters, after all

All the traditional benchmarks remain in play for prospective new hires—work experience, a strong resume, marketable skills, and a magnetic personality—but new research also indicates that attractiveness is much more of a factor than most have been willing to let on.

For example, a recent study conducted at Johns Hopkins University discovered that people with successful nose jobs appear more attractive, more successful, and healthier to other people than they did before their surgery. “While we are not suggesting that [a nose job] is the only way to improve one’s appearance, improving our attractiveness and health as compared to others conveys a competitive advantage,” writes Dr. Lisa Ishii, one of the study’s lead authors.

Other studies have shown that obese candidates are less likely to be hired or promoted than their peers with healthy bodyweights. Researchers have also exposed a clear connection between attractiveness and income, with people who are considered good-looking earning as much as 22% more than their “average”-looking counterparts.

The takeaway here is that a crisis of confidence, particularly when it’s rooted in one’s career, is not baseless. Maybe a cosmetic treatment isn’t the answer for you. But that doesn’t mean you need to accept your life for what it is. Confidence is a funny thing. It can return as quickly as it disappeared. But the longer it goes ignored, the harder it becomes to restore it.

Most men tend to be awkward with anything that involves some kind of social interaction. Blame it on generations of conditioning to never be too vulnerable, not even among those closest to us.

That’s changing slowly, though. And, believe it or not, plastic surgery is an indicator of it. Men have always been concerned about their appearance. I can vouch for that, not just as board-certified plastic surgeon but also as a card-carrying member of the gender. What’s changing is that it’s finally becoming more acceptable for them to say and do something about it. The taboo’s fading.

And it happens to be coinciding with the de-stigmatization of male plastic surgery. It’s easy to imagine that only a few years ago, a guy would never dare tell his best friend that he was thinking about getting Botox to iron out a few premature wrinkles. Today, he’s likely to not only tell him; he may even invite him along.

The number of men interested in undergoing cosmetic procedures is surging. The total number of cosmetic surgical procedures performed among men in 2015 was 1.2 million, according to the American Society for Aesthetic Plastic Surgery (ASAPS). That’s just under 10% of the total number of cosmetic surgical procedures done that year, but it’s more than triple the number of men who went under the knife in 1997, the first year the ASAPS began tracking annual statistics.

The number of men considering plastic surgery is increasing, too, according to the American Academy of Facial Plastic and Reconstructive Surgery. In a recent survey, 31% of men said they were “extremely likely” to consider a cosmetic procedure. A little less than half said a boost in confidence was the main reason for their interest. A quarter said they wanted to “look younger” in an effort to remain competitive in their careers.

Confronting reality

In my most recent blog posts, I’ve tried to unpack how influential our jobs can be—for both men and women—in shaping our interest in plastic surgery. The workforce is growing younger by the year. And where experience once earned you stature, now it’s more likely to render your voice irrelevant. What more and more are seeking, in turn, are ways to sharpen the edges of their experience, if you will. Think nonsurgical cosmetic treatments that can shave a couple years off a face, while maintaining a very natural appearance.

Of course, work isn’t the only reason. At no point in our history have we been faced with more images of ourselves. Even if you maintain a modest social media presence, you still probably see a portrait of yourself when you log into your laptop, send a text, and scroll through your friends’ posts. It can have a cumulative effect. We all have at least one feature we’d like to change. If you’re faced with that feature—say, a receding hairline or prominent forehead wrinkles—a dozen times a day, day in and day out, it has a way of growing roots in our thoughts.

Being particular

The most popular cosmetic surgical procedures for men are liposuction, eye-lift surgery, breast reduction, tummy tucks, and facelifts, according to recent annual statistics from the ASAPS. While not all that different from the top procedures for women, the details of the procedures often dramatically diverge between the two sexes. Rhinoplasty, for example, is not the same surgery for men as it is for women. The same can be said of injectables.

So, if you’re considering male plastic surgery, seek out a board-certified plastic surgeon with extensive experience in treating men. If you can’t find a gallery on their website, don’t be shy about asking during your consultation.

In my recent post, I highlighted a few things to help guide your search for a plastic surgeon and ensure that you find one you can trust. Things like asking friends and family for recommendations, reading as many reviews as you can stomach—but digesting them with a grain of salt, and checking the surgeon’s credentials.

All of that should serve as preparation for your initial consultation with a plastic surgeon, a critical part of the process. Here are a few more tips for what you should be looking for in a plastic surgeon. These are intended to provide you with a framework for the consultation itself and the moments that will follow it, right up to your decision.

Treat the consultation like a job interview.

If you walk into your consultation thinking, It’s the doctor’s responsibility to sell me on his ability to do this procedure, you’re going to miss a prime opportunity to gain some valuable insight into both the procedure and the doctor. Not to mention, those pitches are going to begin to become indistinguishable.

So, just like you would for a job interview, come prepared with a list of questions to ask the plastic surgeon. Go in with the aim of trying to resolve any uncertainty you may have about the procedure and the surgeon. Here are some examples:

• What’s your experience with this procedure?
• Can I see photos of some of your patients who’ve had this procedure, specifically those with my body type?
• Where will the procedure be done?
• I know this procedure is routine and safe, but just in case there’s a complication, are you affiliated with a hospital?
• What can I realistically expect from the recovery, and can I avoid the use of opioids?
• What’s the total cost of the procedure, with all the fees included?

The consultation is also the time when you should express your impetus for the procedure and your goals for it. The former is just as important as the latter because the surgeon may be able to suggest an alternative, less-invasive way to resolve the concern, or a complementary procedure that could provide a more comprehensive solution.

Take note of the doctor’s demeanor, too.

There can be so much emphasis on a doctor’s technical ability and experience that their bedside manner is overlooked. But that’s an important factor to consider for what you should be looking for in a plastic surgeon. Plastic surgery is equal parts science and art, so you should be weary of any doctor who treats this process as formulaic, or who pressures you to undergo a particular procedure.

No matter how often they’ve performed this procedure, they should treat you uniquely, asking lots of questions of their own and openly discussing realistic outcomes. And then they should be willing to give you your space to digest all of that information and decide on your own—and even meet again, if you feel it’s necessary.

Take your time and trust your instincts.

The relationship between you and your plastic surgeon is a personal one. You’re sharing concerns with them, some that you may not even have expressed to your spouse or partner. So, take your time and be patient. If you’ve met with a few doctors and you didn’t connect like you’d hoped you would, keep looking. You didn’t begin this process by settling. Don’t start now.

There’s no disputing that women seek plastic surgery more often than men. But there have been subtle shifts in the year-end data that indicate men are more interested than they’re letting on and a Growing Number of Men are Turning to Noninvasive Procedures to Remain Relevant at Work.

Two of the largest segments of growth are wrinkle reducers and facial fillers. While men made up just 6% of the noninvasive, wrinkle-reducing procedures performed in 2017, according to the American Society of Plastic Surgeons, that number is a 347% increase over 2000. Certain invasive procedures, like liposuction, have also been showing small but steady growth among men.

One of the biggest reasons for the new interest, according to industry experts: a rapidly evolving workplace that, more and more, values youth over experience. We may be living in an increasingly woke culture, but ageism remains a very real thing. Men, in turn, aren’t so much interested in completely erasing their ages as they are adding a bit of credibility by appearing distinguished and, at the same time, young enough not to be irrelevant.

‘We’d be kidding ourselves if we thought looks don’t matter’

Men are Turning to Noninvasive Procedures

Refinery29 recently profiled five such men, ranging in age from mid-thirties to fifties. Speaking from behind false names to protect their identities, they describe a simple, universal desire to look like better versions of themselves.

Steve, a media executive in his late thirties, got Kybella because he’d long been self-conscious about his double chin. Once he realized how quickly it could be resolved, he wasted little time. “In my job, I don’t have the luxury to take five days off. I can’t even take one day off,” he says. “I saw my best friend 72 hours after the procedure, and he still has no clue I had it done.”

Though his motivation wasn’t necessarily tied to his career, Steve says his performance soared. “We’d be kidding ourselves if we thought looks don’t matter,” he says. “No one gets a promotion because of plastic surgery unless they’re in porn. But, does it provide you with additional confidence to do your job every day? Emphatically, yes.”

‘I’m a slightly younger version of myself’

Chris, an advertising executive on the cusp of his 40th birthday, started getting injectable wrinkle reducers and Aquagold facials (a microneedle-type device delivers a small amount of dermal fillers and neurotoxins) to stay competitive in a youth-crazed industry. Valued as experience may be, looking like you earned it is a detriment.

“The perfect balance is somewhere between 35 and 50,” he says. Which is why he didn’t want to erase every line on his face. “I’m OK with maintaining a little bit of wrinkles, just enough so that it looks like I’m a slightly younger version of myself.”

‘I’m able to walk into a room and own it’

Derrick, a 35-year-old freelance stylist, has been getting injectable wrinkle reducers since he was 29 and filler for about three years. “I didn’t have one line on my face, and I still don’t all these years later,” he says.

Recently, he decided to get liposuction, too. Despite a rigorous workout regimen, Derrick felt he was lacking the definition he wanted. After his procedure, his confidence jumped, and his career’s benefitted. “Now I’m able to walk into a room and own it,” he says. “It’s allowed me to land bigger jobs, not because my work is better, but because I’m able to sell myself better.”

You may not know Munroe Bergdorf by name, but you’ve likely seen her fronting any number of beauty campaigns. After years of relying on makeup and fillers, Bergdorf recently underwent facial feminization surgery.

“Your face is how you look at other people, and it’s how you see yourself. You can’t get away from it. When I’d look in the mirror and notice some primary male characteristics, it would make me feel like I wasn’t seeing who I really was,” Burgdorf said in interview with Refinery29. “One of the biggest things that used to freak me out was dressing rooms, because the lighting is so horrendous. There was just something about the way the light hit my brow ridge and showed the width of my chin and nose.”

What is facial feminization surgery?

Facial feminization surgery is an umbrella term that encompasses a broad range of plastic surgery procedures to change masculine facial features into feminine features with the aim of helping transgender women transition physically to their self-affirmed gender.

The surgery can include, among other procedures:

• Nose reshaping: Typically involves reducing the overall size of the nose and its angles.
• Eyelid modification: Excess tissue can be cut away to feminize the upper eyelids.
• Lip lift and augmentation: A lift can shorten the distance between the lip and the nose and create a shorter, more curled lip. While fillers or fat from another part of the body can plump the lips.
• Cheek augmentation: Women tend to have prominent cheeks because they have a greater concentration of fat in the area. Implants or fat from another part of the body can be used to alter the size and shape of the cheeks.
• Mandibular angle reduction: By sculpting or removing outer layers from the lower jaw, the jaw can be reduced and narrowed.
• Chin width reduction: A small wedge of bone is removed to shorten and narrow the chin.
• Tracheal shave: With a small, well-hidden incision, the thyroid cartilage, or Adam’s apple, can be reduced and reshaped.

‘I feel the best I ever have’

“Facial feminization surgery isn’t talked about as much as sex reassignment surgery. People don’t understand how valuable and important facial feminization is,” “Vanderpump Rules” star Billie Lee told Refinery29. “A lot of trans women decide to get facial feminization done way before their sex assignment surgery, or choose not to get sexual assignment surgery at all, and I think that’s really beautiful and brave.”

Both Burgdorf and Lee said they reached a point in their lives where facial feminization surgery stopped being an option and it became, instead, a lifeline.

About a year removed from her surgery, Burgdorf said, “I feel the best I ever have. I didn’t realize how dysmorphic I was about my body until I got that surgery. I didn’t know how much I was holding back in regards to intimacy, either. If you can’t feel a connection with your body, how can you form a connection with somebody else? Getting closer to how I saw myself allowed me to get closer to other people, too.”

Lee echoed the sentiment. “Shortly after the surgery, I was out having fun with friends and I walked past a bathroom mirror and saw myself and I was like, ‘Oh, my God. That’s me,’ ” she said. “Even now, I still have these really powerful moments where I catch my reflection in a store window and it fills me with so much gratitude.”

Too many of us are familiar with the dark circles that can appear under our eyes following a restless night or two. For a surprisingly large portion of that group, however, those circles are a constant, not necessarily because they’re poor sleepers, but because they were simply born that way.

If you count yourself among them, you may have noticed that eye creams and serums only help so much. And that’s because the reason behind the circles’ presence is mostly genetic. Sure, the vicious cycle of tossing and turning at night and overcompensating with too much coffee during the day isn’t helping matters. But those under-eye circles really have more to do with the composition of your skin and the way the light reflects off your orbital bone.

“I didn’t start to notice the dark hollows until I got older, but my baby photos prove that I’ve had them since birth,” says Danielle Gray, a 37-year-old style and beauty writer, in an essay explaining why she got filler to treat her under-eye circles. “[W]hile my under-eye circles have never crippled my self-esteem, they have been hard to ignore, given my line of work.”

Fighting nature with a natural ingredient

If, like Danielle, you’ve only recently become fixated on your under-eye circles, it may be because they become more prominent as we age. Doctors refer to them as tear troughs. The skin around our eyes is thinner and paler and lacks the proper fat restores, so the indentations grow a little deeper, giving the eyes a more tired appearance.

Discouraging as that may sound, it’s actually fairly easy to remedy—in the right hands. With a small layer of precisely placed hyaluronic acid gel, the delicate skin is lifted up and away from the blood vessels under the eyes.

Hyaluronic acid is a natural part of the skin’s dermis, but it diminishes as we age, which causes the hollowing effect under the eyes. The filler helps pull water to the site of the injection, creating a plumper under-eye and a rejuvenated appearance.

The placement of the injections is critical. The filler needs to be planted quite deep so it isn’t visible under the delicate under-eye skin. (A topical numbing agent can be applied beforehand to ease any discomfort, and it’s a very small needle, so the injections are virtually painless.) Which makes finding a board-certified plastic surgeon with lots of experience with the procedure critical to a good outcome.

If the idea of getting injections around your eyes is still a bit daunting, lasers can also help with dark circles, especially if they’re caused by visible blood vessels.

‘Do what makes you happy’

“Once I was healed completely, I was in love,” Danielle says. “My dark hollows were gone and I was thrilled with the way I looked with and without makeup.”

Within a day or two of the hyaluronic acid treatment, your eyes will appear noticeably brighter—though the change will be subtle enough that you’ll be the only one able to spot the difference. That effect should last anywhere from six months to a year, depending on how quickly you metabolize the filler and the type that was used.

“Over the years, I’ve learned that you can use a little something to preserve your skin—whether it’s sunscreen, a chemical peel, or, in my case, under-eye filler,” Danielle says. “The key, in my opinion, is to make informed decisions about the choices you are making for you. Do your research and, ultimately, do what makes you happy.”

Sir John, the celebrity makeup artist whose clients include Beyoncé, Serena Williams, and Priyanka Chopra, recently went public with his decision to get microneedling and facial filler.

He was prompted, he said, to learn more about both minimally-invasive cosmetic procedures after Lifetime’s “American Beauty Star,” the show on which Sir John serves as a judge, first came out.

“I thought, Damn, I look so tired. When you see yourself from the outside, you start to look at yourself objectively,” Sir John told Refinery29. “For me, being on TV was like looking in a mirror, and I was very self-conscious about my eyes.”

He underwent microneedling first. Also known as collagen induction therapy, microneedling stimulates the body’s own natural healing response, dramatically improving skin tone and texture. The result is firmer, more radiant skin.

Microneedling suits all skin types and colors. It’s most often used to target:

• Wrinkles and fine lines
• Uneven skin tone
• Sun damage
• Acne scars and other types of scarring
• Enlarged pores

As we age, our skin’s ability to produce collagen naturally slows down. Microneedling helps replenish those stores. And unlike other treatments, it’s safe enough to use around the eyes, so it treats the entire face.

Soon after, Sir John underwent his first round of facial fillers.

“I only thought of [filler] to be one thing, which was going to make me look tight and plastic. But nowadays, there are so many conservative ways to use these ‘helpers,” as I like to call them,” he said.

“After I got the filler, I walked out … feeling like Superman,” he said. “We all have something we want adjusted, corrected, or revised. When that happens, it feels good and moves the needle emotionally. It changes our sense of wellbeing.”

Facial filler is an umbrella term that encompasses a nuanced range of injectables. The majority are made of hyaluronic acid, a safe sugar found naturally in the human body. Hyaluronic acid fillers act kind of like place holders, substituting for depleted collagen and fat.

Fillers made from other materials are known as biostimulatory fillers. They include Radiesse, which is made from a mineral found in our bones and teeth, and Sculptra, which uses poly-L-lactic acid, the same biodegradable component that’s used in absorbable stitches.

The main purpose of biostimulatory fillers is to spark the growth of your own collagen for longer-lasting fullness and lift. (Hyaluronic acid fillers have also been shown to increase collagen and elastin production over time, but to a lesser extent.)

“I didn’t have any reservations as a man—that’s the last thing that crossed my mind,” Sir John said of getting facial filler. “These things have absolutely no gender. I’m a beauty guy and [I’m] also around really strong women who impact real change all around the world. One thing I have always learned from women like Beyoncé and Serena is that they never allowed people to put them into a box.

“However, I was apprehensive because there are other cultural barriers to accepting something like filler,” he said. “We’ve grown up with so much toxic masculinity and stereotypes of machismo in the Spanish and black community, so I’m coming from a place that some might call rebellion or enlightenment—depending on who you ask.”