In the past six years, botulinum toxin (more commonly known as Botox) usage has increased 101 percent. In the past 20 years, overall aesthetic procedures for men has risen 325 percent, according to the American Society for Plastic Surgery. That’s not just Botox, guys. The ASPS also reported that the trend is up with other injectables as well — 26.6 percent for hyaluronic fillers from 2014 to 2015 alone. If you think that must be a farce, Allergan — owner of the Botox brand, as well as Juvederm (hyaluronic acid to fill) and Kybella (deoxycholic acid to reduce fat) — did a study and found almost half of the men polled were willing to spend money on their facial appearances, with 40 percent willing to spend over $250 for a single treatment. Sound expensive? Well, there is such a demand for injectable maintenance procedures, that Allergan has recently launched it’s Brilliant Distinctions program where you can earn points for keeping up with the injections.
We talked to the leading authority in men’s aesthetics, Dr. Terrence Keaney MD, FAAD, who recently opened Skin DC Dermatology in Arlington, Virginia and almost exclusively focuses on men. Not only did he talk about what men are getting done, but how and why they are getting it done differently than women.
“A new male patient will come in with a general complaint — they look in the mirror and they don’t like what they see,” Dr. Keaney tells The Manual. “Often, on the face, there are two areas of concern, aside from hair loss: looking tired around the eyes and a lack of jawline definition. I call them the three lines: hair, eyes, jaw.” He tells us that these are referred to as the “chief complaints”, which often lead to the discussion of injectables. These sound relatable, right? Here are the ways that men can start attacking these concerns early without fear of the dreaded frozen face.
Eyes
“For the eyes, men often describe being tired. They are also more commonly getting eyebrow ptosis, or hooding of the eyebrows. Men’s eyebrows sit lower and, as we age, they get even more sunken in,” Dr. Keaney says. “The muscles between the men’s eyes are stronger [than women’s], so they tend to get this U-shape furrow between them.” In addition to the area in between the eyes, men have a slightly different need with their crows feet as well. “The crows feet point downward on men,” instead of upward as they tend to do on women.
So what does all of this mean? Since looking tired is what men are most concerned about — rather than forehead wrinkles, which is often associated with Botox — it may surprise you that Dr. Keaney can use Botox to fix a droopy brow as well. “By leaving the forehead untreated, I can instead treat the eye area and use the forehead muscle to essentially open their eyes. With new guys who aren’t familiar with injectables, the big concern is looking overdone.”
So this trick opens up the eyes, but what about the bags underneath? “I’ll often use a filler product, like Juvederm, to treat the teardrop area to help the hallowing, tired look under the eye.” This treatment area is what is called off-label. Should that term concern you? No. Often these injectable products are tested off-label by trusted dermatologists who know what they are doing and what to expect from different injectables. This is how new discoveries can be made, which allow for new treatment areas to be approved by the FDA later on.
“That’s a great combination approach that men like — I’m opening up their eyes [with Botox] and filling in the sagginess underneath [with Juvederm], while still allowing them to look natural,” he says.
Jaw
“Once again, it’s a combination injectable approach. The challenge with men is we have less fat in the face, so we’re inherently more angular,” Dr. Keaney explains.
This means we, as men, should steer clear of plumping our lips and cheeks if we are trying to maintain, or regain, any sort of youthful appearance. “It’s a different injection technique I have to talk with men about. I say, ‘We’re not going to give you big apple cheeks. We are trying to maintain your sharp cheek line but also lift up the sagging jowls.'”
Fillers now come in various thicknesses as well, such as Juvederm Volbella (thinner, for the under eye area), and Juvederm Voluma (thicker, for the chin and jawline). Add to this Kybella, a fat-dissolving acid, and you have a potentially long-lasting jawline enhancement that can be performed over your lunch break. “You’re exposing the jaw by lifting it up as well as defining the jawline by getting rid of the fat underneath it. Us men are made up of angles creating shadows, not soft curves,” Dr. Keaney elaborates.
How to Prevent Wrinkles
“The biggest prevention method would be Botox,” Dr. Keaney says. So, yes, preventative Botox is a thing. “If you minimize how strong the [upper face muscles] are, those lines never settle in.”
But, even to our surprise, Dr. Keaney gave another method he offers to his clients as a prevention option.: “If a guy has a less masculine face shape or doesn’t have a strong jaw or jawline, that allows us to use filler in younger guys.”
Since the thicker fillers last up to two years, it’s as easy as a doctor’s check-up (literally) with a trip in every year and a half or so. This allows for a slight add-on effect over time. “So, this may be less preventative and more treating something genetic, like a double chin. Guys can be in great shape but still have a little extra fat under their chin, and with Kybella, I’m able to address that much earlier.”
There is no magical age to start getting injections, and there are no studies to determine cost over time, but Dr. Keaney thinks there may be benefit to starting as early as your late twenties if you really want to stave off aging without doing it all at once late in life. “Men age more poorly than women. We start developing fine lines and wrinkles earlier. If we want to get on top of fine lines, it’s wise to start Botox in the late twenties. For jawlines, you’re talking about starting in the mid-to-late thirties to early forties when you start seeing subtle changes that you would use Juvederm for. Chin fat: usually mid-thirties for guys.”
There isn’t an exact time that any one person knows when to go in for an injectable procedure. You don’t wake up one day and say, “OK, it’s time to go in for Botox now,” because every man ages differently. By finding a regular dermatologist and bringing up these concerns when you’re in his or her office, you can get started on a fun-filled ride to a younger, more handsome self.
