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Psychologists tend to view issues from different perspectives, which is how I approached the recent Wall Street Journal article describing the rise of plastic surgery among men. On the positive side, this trend suggests that men may better understand the anti-aging pressures that women have faced for so many years. On the negative side, the closing of the ‘beauty gap’ means more men will be joining women as they slide down a potentially precarious — not to mention costly — slippery slope. According to the American Society of Plastic Surgeons, a total of 1.1 million men underwent cosmetic procedures in 2010, representing a two percent increase over the previous year. Although this growth did not match the five percent increase found among women and still only represents nine percent of all cosmetic work done in the U.S., several particular procedures — i.e. facelifts, eyelid surgery and liposuction — were markedly greater among men. And, in the past ten years, there has been a 77 percent increase in cosmetic procedures performed overall, suggesting that in spite of difficult financial times, more men and women are finding ways to fund ($10.7 billion) alterations to their appearance. The Wall Street Journal article, “Younger Men Seek Cosmetic Surgery as Stigma Fades, Recovery Gets Easier,” came as no surprise to me. Over a year ago I described this narrowing gender gap in a piece entitled, “Men Need a Lift Too.” I wrote, “Whether men are talking about it or not, they too are beginning to experience complicated feelings about their changing looks that are worth exploring further. The parallels between men and women are clear. The differences are becoming less clear. We are all living in a culture that is increasingly equating youth with attractiveness and sex appeal, one that has virtually programmed us to have a crisis over an aging appearance.” And just last week, I spoke on the “Today” show about the decreasing stigma attached to men who color their hair, a grooming practice that is fast becoming routine among men today. I pointed out that as more women are letting their silver locks show, more men are covering theirs — another sign of the narrowing beauty gap, or as I called it, the ‘gray gap.’ Clearly, cosmetic practices are changing and the double standard is lessening, but where this is all heading is not as clear. David Sarwer, an associate professor at the University of Pennsylvania and researcher at the Center for Human Appearance says, “Men are figuring out what women have long known — that appearance really does matter.” He and others at Penn studying the role looks play in our lives report that, “people who improve their appearance tend to feel better about themselves, and while we can be critical about what that is saying about us as a society, we need to consider the individual.” According to Sarwer, this applies to both women and men. We are finding that there is a simultaneous decrease in the stigma about male grooming alongside an increase in the desire by men to use their improved looks to remain competitive professionally and personally. So, while it may be reassuring that men are joining women down this cosmetic slippery slope, it raises concerns similar to the ones I expressed several years ago about the general impact plastic surgery has on contemporary culture. The issue discussed in “Cosmetic Drugs Gone Too Far” was at that time provoked by the excitement over the new product Latisse, an eyelash enhancer that had recently become popular in the mass market. Much the way Retin-A cream and Botox originally served to treat medical symptoms, Latisse was once intended to treat glaucoma, a disease of the eye. It was only after the unexpected side effect was discovered — it thickened lashes — that Latisse begin to be marketed for cosmetic purposes. I questioned the popularity of this new trend, asking, “Was it a miracle drug for what marketers were now calling ‘inadequate lash syndrome,’ or just another way for women to feel the need to fix what our culture deemed needed fixing?” We have gone from furtively asking just a few decades ago, “Does she or doesn’t she?” — the old adage about hair dye — to now wondering, “Has she or hasn’t she?” In fact, these days we don’t have to wait for the answer since there is a growing openness about plastic surgery among women. When Jane Fonda went on Oprah and was asked how she looked so fantastic at age 73, she responded, “good work.” No one questioned what she was talking about and she was applauded loudly for her honesty — perhaps one of the positive outcomes of our candor about the topic. While men may not be ready to be so up front about their ‘good work,’ are they otherwise headed in that same direction? On a recent Today Show, media expert Donny Deutsch said men are visiting salons for all sorts of cosmetic attention — from hair coloring, pedicures, manicures and even waxing — but few are owning up to it. Howard Sobel, a Manhattan dermatologist, disagrees with Deutsch. He says men are becoming increasingly open about it all. He reports that not long ago “men who came into his office for a cosmetic procedure would ask to come in the back door or ask to be seated where no one could see them. They have become less shy — and willing to sit in the waiting room.” He added, the healing process following treatments like Botox, lasers and fillers are less visible, so men no longer need to hide the purpose of their visits. They walk in and out, Sobel says, and most are happy with the results. Again I ask — as I did about women — does this shift reflect greater comfort with new and improved cosmetic options or are men joining women down a dangerous slippery slope created by our beauty culture? How soon will we all be asking, “Does he or doesn’t he?” I suppose I am looking beneath the surface — another thing psychologists do — and thinking long term, anticipating that once headed down that path, men may find it’s not so easy to get off. There are women who say in retrospect they wish that they had never started. I’m not talking about the celebrity horror stories we hear about on “cosmetic surgery gone bad.” I’m talking about everyday women who start work on their crow’s feet or eye lids, then move downward to their lips, then neck, arms and even to their hands. (Yes, hand rejuvenation has been added to the procedure list!). As Dominique Browning concurred in the recent New York Times piece, “The Case for Laugh Lines,” a little nip here and tuck there can lead to makeovers that leave women unrecognizable. “Who are you?” Browning asks — and many of us think — as the people we know “are erasing the traces of identity, if not life, from their faces.” The women I interviewed for my book “Face It: What Women Really Feel As Their Looks Change” said their cosmetic choices often originate out of the fear of looking older, but that surgical procedures gradually become a way of life. Although some are very happy with the results, the ones who made radical alterations often express ambivalence — there is just something ‘unsettling’ about making changes to one’s body that cannot be undone. Will men soon be staring in the mirror, as women did for decades, wondering if “a little bit of this or that and life will be better?” “Will a new body improve my relationships or a new face bring success at work? Will men become plastic versions of their real selves and fall victim to this cultural trend gone too far? We know we are living longer and many of us expect to look and feel vital well past midlife. But shouldn’t we focus on changes to our attitudes rather than the ones on our faces and bodies? No doubt health and cosmetic routines aimed at prolonging our vitality are here to stay as we live well into our 80s and 90s. No doubt more men and women will be relying on health professionals to help us meet the challenges of aging — from heart specialists and dermatologists to physical therapists and fitness trainers. But I believe we need to shift our efforts from turning back the clock to moving forward, and doing so with courage, vigor and grace — qualities that are not gender specific. Maybe, just maybe, we can learn from each other, men from women and women from men. The barriers are being broken — guys are paying attention to their appearance and gals are finding less radical ways to deal with their aging looks. But let’s use these broken barriers to benefit from one another. For both men and women, I suggest we seek reliable, healthy options to feel vital and look attractive as we age and carefully question the role cosmetic procedures will play toward that end. What do you think about the rise in cosmetic surgery among men? The more open we are about this issue, the more informed we will all be about the choices we make toward healthy living. **** Vivian Diller, Ph.D. is a psychologist in private practice in New York City. She has written articles on beauty, aging, media, models and dancers. She serves as a consultant to companies promoting health, beauty and cosmetic products. “Face It: What Women Really Feel As Their Looks Change” (2010), written with Jill Muir-Sukenick, Ph.D. and edited by Michele Willens, is a psychological guide to help women deal with the emotions brought on by their changing appearances. For more information, please visit my websites at www.FaceItTheBook.com and www.VivianDiller.com. Friend me on Facebook (at http://www.facebook.com/Readfaceit) or continue the conversation on Twitter.