Even after Chris Sanford lost 130 pounds, he struggled with body dysmorphia. Every time he looked at the streamlined bodies on his social media feed, he was reminded about the folds of excess skin drooping from his own torso. It made him feel far larger than he really was.
“It prevented me from understanding actual body size,” said Sanford, who said he avoided tight clothing to hide his physique. “Before the surgery, I would go in [to clothing stores] and still want to pick up a 2XL, something much larger.”
So the 31-year-old from Oklahoma City went in for extensive plastic surgery: a double breast removal and skin removal on his chest, an extended tummy tuck around the waist line, and liposuction to remove fat from his abdomen and transfer it to his butt. The results were transformative, and not just for his appearance. He felt far more self-assured — enough to date.
“I’m very happy with my results and very confident and happy with my body,” he said. Even so, this might not be the end of his cosmetic surgery journey: “Once you fix one thing, you can find other things to pick apart.”
With Instagram’s proliferation of sculpted bodies and many workers spending hours a day staring at their own faces on Zoom, men like Sanford are increasingly turning to plastic surgery to deal with raging insecurity about their looks. Last year,1.6 million cosmetic surgery procedures were performed on men, according to the American Society of Plastic Surgeons (ASPS), 4% more than in 2022. (The society changed its methods in 2022, so earlier figures aren’t directly comparable.)
It’s a symptom — along with the roughly 2.2% of men suffering from body dysmorphia and rates of eating disorders increasing faster among men than women — of how the social pressures of maintaining a perfect body in an appearance-obsessed world are wearing on men.
“With the rise in social media and seeing images that are curated and perfect, men are now living in the same world women have been living in where you’re expected to have perfection,” said Christia Brown, a psychology professor at University of Kentucky. ”You’re seeing men become less happy with how they look.”
Historically, girls had worse body image than boys, she said, but in recent years, that gender gap has narrowed, if not disappeared. “As we see more men that are highly idealized in terms of what they look like, we become susceptible to those ideal images,” she said.
The most common procedures are gynecomastia (breast reduction in men) and liposuction, followed by eyelid surgery. But it’s not just men who are struggling with their weight. As with women, many older men want to look younger.
Douglas Steinbrech, a plastic surgeon with offices in New York, Los Angeles, and Chicago, created five iconotypes of the men who get plastic surgery: the male model/actor, the father next door, the chief executive, the bodybuilder, and those who’ve had significant weight loss.
Steinbrech said he sees a lot of board room executives in their 50s, 60s, and 70s. “They’re afraid they’re going to lose their deal if they look like somebody’s grandfather.” Sometimes they also want to attract younger dates, he added, but “mainly it’s business.”
Steinbrech started to attract men to his practice a little over a decade ago, once he finished his residency and noticed the vast majority of plastic surgeon websites didn’t have any photos of men. He built an educational website featuring entirely men and immediately began to bring them to his practice. His patients are now 98% men.
Lara Devgan, a plastic surgeon in New York, said 15% to 20% of her patients are male. Men working in finance and business “want to feel more vigorous or competitive in a workplace,” she said. “It’s very common for a CEO to have a neck lift when he has a week off work.”
Devgan said she’s noticed a gradual rise in men getting plastic surgery over the past five years — though women still account for 94% of procedures nationally. “I think social stigmas are decreasing as there’s more sharing around plastic surgery,” she said. People are more likely to share about their own procedures on social media. Sanford said he was inspired by accounts that talked about skin removal procedures, and has posted about his own surgery on TikTok.
Broader social trends are contributing to the increase. The last five years coincide with the pandemic-driven shift to people working from home and being glued to video conferencing apps.
“It’s like looking in a mirror all day long on these conference calls,” said David Sarwer, a professor of social and behavioral sciences at the Temple University College of Public Health who has studied the psychological aspects of cosmetic surgery for over 30 years. Plus, whether it’s tattooing or surgery, he said, we’ve become more comfortable moderating our bodies as a way of expressing who we are to the world around us.
Wellness trends, including the focus on longevity and biohacking, have contributed to the plastic surgery search for perfection. “The bar has been raised. Everyone’s got abs,” said Steinbrech. “You’re seeing guys with more sculpted faces and sculpted bodies. That’s becoming a new norm.”
Michael Keyes, a Miami plastic surgeon and member of ASPS, said his clients tend to be in good shape but are still not satisfied. For these clients, he performs high-definition liposuction, which creates shadows around the muscles, and then injects the harvested fat into the muscle to make them pop out more.
“I can’t tell you how many people come in who are in great shape, have trainers, eat well,” said David Shokrian, a plastic surgeon in New York and Miami. “There are certain results they’re not able to achieve, no matter how much they diet and exercise.”
Social media in general has a huge effect on the desire to have plastic surgery, said several surgeons. In the past, people might have wanted plastic surgery after attending a high school or college reunion, but now there are constant reminders of how old friends look on social media, Shokrian said. Dating apps are another factor. “When looking at dating apps, the first thing you’re presented with is an image and you make a snap judgement based on that so that definitely is a driver,” said Christopher Funderburk, also a plastic surgeon in New York and member of ASPS.
Even if you know the photos are edited, they have an effect. “Our eyes more commonly see perfect bodies,” said Joubin Gabbay, a Beverly Hills, Calif., plastic surgeon. There are more people looking at the photos you post, and more images of people in peak physical shape. “For good or bad, that does push you to think, maybe I have to do something about my body,” said Gabbay.
There are risks to the procedures, up to and including death, though more common bad reactions are contour irregularities. With more involved surgeries like tummy tucks, risks include collection of fluid under the skin, infection and bleeding, blood clots, deep vein thrombosis, and pulmonary embolism. An allergic reaction to anesthesia is also possible — or simply not liking the results of the surgery.
Body image makes up about 30% of our overall self-esteem, said Sarwer, but he said while some studies find self-esteem improves after surgery, others find no change.
About 5% to15% of both men and women having plastic surgery are likely to have body dysmorphic disorder, meaning if a practice has 20 new patients in a week, one to three will have the condition. These patients frequently don’t feel any better about themselves after the procedure and can feel worse, Sarwer said. Young patients requesting face lifts or other procedures designed for older adults are the kind of patients to avoid, he added.
Devgan said she tries to screen out patients who aren’t in a good physical or mental place for procedures. “At its best, plastic surgery is a vehicle for confidence,” she said. “I think it can be a very empowering experience and can really help people feel they’re maximizing how they present themselves to the world. There’s so much about appearance that reflects on identity.”
STAT’s coverage of health challenges facing men and boys is supported by Rise Together, a donor advised fund sponsored and administered by National Philanthropic Trust and established by Richard Reeves, founding president of the American Institute for Boys and Men; and by the Boston Foundation. Our financial supporters are not involved in any decisions about our journalism.
