Bruce Hildebrand, 60, was working for the U.S. Department of Defense in 2001 when his wife noticed a crease between his eyes that made him look "angry."
He got even with his wrinkles — the following year, he went to a plastic surgeon to get the first of six Botox injections.
"I think I felt more confident after I had it done," says Hildebrand, who is now retired and about to have a face-lift. "If there's a nice way to remedy the effects of aging, then I say, 'Why not?' "
They're exercising, they've quit smoking and they're eating more healthy foods. But men who end up in the plastic surgeon's chair often say they don't think they look as good as they feel, according to doctors. Some patients are fresh off a divorce or looking for a competitive edge in an office full of young bucks. Others are inspired by wives who have had successful procedures — or are kind enough to ask why their husbands' once-smooth brows now appear permanently furrowed.
From 2000 to 2005, there was a whopping 44 percent increase in minimally invasive cosmetic procedures among men, according to the American Society of Plastic Surgeons. While the jump in demand isn't unique to the gender, doctors say it speaks to many men's desire to boost their looks — often through quickie treatments that don't cause a lot of bruising or require lengthy recovery times.
"Men want to know, 'When am I going to be really ready to go back to the office?' " says Dr. Richard D'Amico, president elect of the ASPS and a plastic surgeon in private practice in Englewood, N.J.
Top three most popular procedures
For many of those patients, that means getting minimally invasive cosmetic procedures such as Botox, microdermabrasion or laser hair removal, the top three most popular among males last year. (For the rest of the Forbes list, view the slideshow.)
Among cosmetic procedures, figures from the ASPS show that the number of Botox treatments increased 233 percent from 2000 to 2005 among men, with an estimated 313,519 injections of toxin. Dr. David McDaniel, Virginia-based director of the Institute of Anti-Aging Research, credits the mainstream acceptance of Botox and the fact that more doctors have mastery of the technique, making patients look less frozen and more natural.
"As a guy in the public eye you want people to think you look really good, really rested, like you're eating all your fruits and veggies," McDaniel says. "You don't want people to think, 'I wonder who did his Botox?' "
Liposuction on the rise
Despite the rise of in-and-out procedures, cosmetic surgical procedures such as nose reshaping, hair transplantation and liposuction also remain popular among men. Men's liposuction, which involves the removal of excess fat through a suctioning device, went up 10 percent from 2004 to 2005, based on ASPS figures. The typical male request involves the lower back, upper flanks and abdomen, otherwise known as the "spare tire," D'Amico says.
"These are not lazy, obese people," D'Amico says. "We're talking about people out there dieting and exercising but there are limits to what we can achieve with that. This is a reward for all that hard work."
Removal of fat from under the chin, which can leave a tell-tale oily spot on a man's tie knot, is becoming more common, too, says Dr. Darrick Antell, a New York-based plastic surgeon and a spokesman for the ASPS.
Looking to the future, doctors say they expect tummy tucks and body lifts to show dramatic growth due to the popularity of gastric bypass surgery. Patients can lose hefty amounts of weight following the surgery, leaving them with unattractive, baggy folds of skin.
Though minimally invasive procedures are up for men, the number of women who pay visits to the plastic surgeon is still far greater. Dr. J. David Holcomb, president of the Florida Society of Facial Plastic and Reconstructive Surgery, guesses that if as many men begin having different procedures done as women there aren't currently enough doctors to handle the patient load.
"They're the biggest untapped market," he says.