Gender Differences when Considering Aesthetic Treatments

Massaging the face – or the message?

Men currently represent a small portion of people pursuing aesthetic treatments, about 10%-20% of the population (Frucht & Ortiz, 2016), but that number is undeniably growing. Consultations with aesthetic practitioners are rising among men due to a number of factors, including the increasing normalization of seeking cosmetic treatments and the growing availability of minimally invasive treatment options. Societally, men are experiencing more pressure to look younger, both due to competition in the workplace and through the emphasis on male grooming in (social) media. When advising male patients, a two-pronged approach is necessary, one that considers their anatomical gender differences and perhaps even more importantly, one that reassures the outcomes will favourably enhance masculinity and that downtime and stigmatization will be low or non-existent. 

Top Considerations when Approaching Male Patients

The first thing to consider is that the pool of research and data on male injectables is based on a relatively small cohort of patients. The studies which this article surveyed used semiquantitative data, retrospective and uncontrolled analysis, and it is noted that there are very few anthropometric studies that analyze different migrant ethnic groups in the United States (Sadacharan, 2016). That being said, some general truths have become evident. 

The treatment most sought after by men involves the sculpting of the chin and jawline. Due to worries about feminine or unnatural outcomes and potential side-effects, discussion that focuses on the lower third of the face was proven more favourable and differed from the typical approach with female patients which puts more emphasis on the upper third. Due to other anatomical, physiological, and behavioural differences in the aging male face, special attention to technique is absolutely essential for men requesting neurotoxin injections. Men have larger foreheads resulting in the need for more injection sites (Frucht & Ortiz, 2016). They also have lower brows where injections that are too low or potent can result in ptosis. Care should also be taken to avoid creating a central or lateral brow lift possible due to their flatter brow, resulting in a more feminizing look. Men have more skeletal musculature than women likely resulting in more facial musculature and therefore prominent dynamic facial rhytids. Men also tend to have more sebaceous skin and may therefore be more inclined to seek treatment for sebaceous hyperplasia (Frucht & Ortiz, 2016). 

Possibly due to a lack of awareness of all available options, BoNTA injection is the single most commonly performed cosmetic procedure with male patients, whereas fillers are generally less popular (Mastroluca et al. 2021). One study shows that BoNTA with a high G’ and cohesivity such as the VYC-25, a novel HA filler from VycrossTM, are very effective in minimizing lateral spread and it may be more cohesive and less prone to migration than biphasic alternatives from some other product ranges; “Thus, VYC-25 offers enhanced potential for sculpting and contouring of the chin and jaw area, with proven effects on facial angles, high rates of patient satisfaction, and durable results lasting at least 18 months. Injection of filler into the mandibular angle may be used to produce a stronger posterior jawline, while use along the length of the body of the mandible may augment the inferior jawline.” (Mastroluca et al. 2021). Despite the substantial volume of filler used, there were no major or delayed complications throughout up to 12 months of follow-up. 

Perhaps equally important in the cosmetic treatment of men is the consideration of behavioural science in addition to anatomical science. Studies show that a reassuring  approach in consultations is essential, calming worries about unnatural or feminine outcomes. Men also possess a lower tolerance toward longer-term side effects and post-procedure edema and erythema which may require masking agents such as make-up, which they are also less likely to use. All of this is due to a lingering stigma that is more persistent among men than women pursuing treatment at this time. Like women, men find facial symmetry desirable, however men often do not desire complete eradication of dynamic rhytids, preferring instead to have them softened (Frucht & Ortiz, 2016). In the context of cosmetic intervention, the exaggeration as opposed to restoration of certain male features can also result in an aggressive or threatening appearance, such as an overly protruding chin or severe brow,  whereas the accentuation of feminine features tends to have a “feminizing” effect (Frucht & Ortiz, 2016). 

With men seeking cosmetic treatment, anatomy and language can both be considered essential. Putting patients at ease at the consultation stage was central to ensuring that they then returned for treatment. Likewise a desired outcome, most often involving a ‘remasculinization’ of the chin and jawline, with a focus on the lower third of the face,  will go a long way to securing a returning client. Facial morphology can vary due to a number of factors such as gender, race, diet, climate, and environment, and studies show that the aesthetic standards of a particular group may not suit other patients belonging to diverse racial and ethnic backgrounds (Sadacharan, 2016). While more studies and research need to be done, male cosmetic treatments are on the rise and will continue to be if targeted efforts are made toward proper consultation and outcomes.

References

Mastroluca E, Patalano M, Bertossi D. Minimally invasive aesthetic treatment of male patients: The importance of consultation and the lower third of the face. Journal of Cosmetic Dermatology. 2021 Jul;20(7):2086-2092. DOI: 10.1111/jocd.14231. PMID: 33993643; PMCID: PMC8361772.

Frucht CS, Ortiz AE. Nonsurgical Cosmetic Procedures For Men: Trends And Technique Considerations. The Journal of Clinical and Aesthetic Dermatology. 2016 Dec;9(12):33-43. PMID: 28210397; PMCID: PMC5300725.

Sadacharan CM. Vertical and horizontal facial proportions of Indian American men. Anatomy & Cell Biology. 2016 Jun;49(2):125-131. DOI: 10.5115/acb.2016.49.2.125. PMID: 27382514; PMCID: PMC4927427.