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\s=b\Just like their female counterparts, men are increasingly turning to facial plastic surgery, but male patients bring to the surgeon an array of unexplored motivations and expectations along with unresolved emotional conflicts. These feelings of ambivalence, emotional instability, and sometimes even hostility toward the surgeon make the male aesthetic patient more of a psychological risk than the female aesthetic patient. This article focuses on how the surgeon can recognize and control the male patient's emotional disturbances and, consequently, better serve his patient and protect himself.A few decades ago there was a definite stigma against aesthet¬ ic (cosmetic) surgery. This attitude has gradually faded, and today society willingly accepts aesthetic surgery. Furthermore, and probably within the past decade, aesthetic surgery is no longer largely limited to women. Men are also seeking aesthetic surgery and they are up-front about it. This change in attitude adds to the aesthet¬ ic surgeon's problems. He must now realize that he cannot use the same method for psychologically evaluating both male and female patients.On the assumption that previous psychological studies have dealt pri¬ marily with the female aesthetic patient, this article focuses on the male patient and addresses one question in particular: Is the male aesthet¬ ic surgery patient more of a psycho¬ logical risk than the female patient? Keeping this question in mind, I will discuss four major topics: the increase in male aesthetic surgery; the psycho¬ logical differences between male and female aesthetic patients; the dynam¬ ics underlying the emotionally dis¬ turbed male patient; and the treat¬ ment and management of the male aesthetic patient. INCREASE IN MALE AESTHETIC SURGERYGoldwyn,1 in his excellent book The Patient and the Plastic Surgeon (1981), states that 85% of aesthetic surgery patients are female. Prior to Goldwyn, Baker,2 in his study of 1500 face-lift patients (1975), found that only 4% of the patients were male.Two years later he found that the percentage of male patients had dou¬ bled. Finally, in a recent poll (1986) conducted by Cash et al,3 45% of the women interviewed indicated that they would have cosmetic surgery, while 33% of the men stated that they would consider it. Other studies and observations bear out the increase of both the acceptance and the occur¬ rence of male aesthetic surgery.These percentages tell us only one fact: male aesthetic surgery is increasing. We have only speculative theories as to why aesthetic surgery has been largely devoted to women, and as to why male aesthetic surgery is increasing. PSYCHOLOGICAL DIFFERENCES BETWEEN THE SEXESMost authorities agree that the pre¬ ponderance of female aesthetic pa¬ tients stems from cultural, social, and psychological factors. Goldwyn1 states that "our culture places a higher value on the attractive appearance of the woman than that of the man ... that the woman, deprived of many sources . of gratification available to men, has learned to use and value her b...

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All surgery has a psychological impact, but nowhere does the patient's psyche come into play more prominently than in the field of elective surgery. Psychological manifestations related to elective surgery must be recognized and controlled preoperatively, lest they control the operative outcome. This article discusses the personality characteristics associated with the potential problem patient; counseling and evaluative techniques; common psychogenic conditions; cause and management of patient dissatisfaction; and psychology of the terminal patient.