NEW YORK -- People used to think cosmetic surgery was just for women, but more men are having it done every year, and not necessarily for the same reasons.

Men had more than 1 million cosmetic surgery procedures last year, up 256 percent from the previous four years. So why the increase? Looking good is part of it, but it may also make good business sense.

People turn to plastic surgery to look younger and more beautiful. But 31-year-old Joshua Schwartz had more practical concerns.

"Basically I had these big fatty bags since I was born under my eyes. Kind of like almost 10 times worse than when you have a bad night of sleep and you get those bags under your eyes. I had it 10 times worse, always, whether I would get a great night's sleep, or didn't sleep at all," Schwartz said.

Other people noticed, too.

"Everyone would always say, you know, 'God, you look tired, you look tired.' So after a while, when people start to tell you that, you start to believe it," Schwartz said.

To fix it, Schwartz went where no man used to go before. He had his eyes done.

Surgery around the eyes is the third most common cosmetic procedure performed on men. Others in the top five are liposuction, nose jobs, removal of breast tissue and facelifts.

"As technology has improved, as we do more and more limited or minimal types of surgical procedures, that has allowed more male patients access to plastic surgery, because we're not dealing with visible scars or scars that have to be camouflaged by makeup, which most men don't have an interest in using. That's made them more amenable to these types of procedures," Dr. Robert Herbstman said.

So does the pressure to make a living. A lot of men feel cosmetic surgery gives them an edge on the competition.

"People who are in sales, or people who are in a people-oriented business and come in contact with a lot of people during their work day want to maintain that look of energy basically -- they're energetic, they're aggressive in the workplace, in the sense that they get the job done and they're active and they want to have that fresh look as opposed to looking like they rolled out of bed after a poor night's sleep," Herbstman said. "I don't know that it makes a difference, but it certainly makes them feel more confident in the workplace."

"It always helps you to try to look your best, no matter what you do. In that way, it's helpful, I guess," Schwartz said.

Another popular cosmetic procedure is hair transplantation. And some men are even getting calf and pec implants, but the surgeons say those are the most popular in California.