The Male Aesthetic Patient: Facial Anatomy, Concepts of Attractiveness, and Treatment Patterns

January 2018 | Volume 17 | Issue 1 | Original Article | 19 | Copyright © 2018

Terrence C. Keaney MD FAAD,a,* Robert Anolik MD,b André Braz MD,c Michael Eidelman MD,d Joseph A. Eviatar MD FACS,e Jeremy B. Green MD FAAD,f Derek H. Jones MD,g Vic A. Narurkar MD,h Anthony M. Rossi MD FAAD,i and Conor J. Gallagher PhDj

aSkinDC, Arlington, VA bLaser & Skin Surgery Center of New York, New York, NY cPrivate Practice, Rio de Janeiro, Brazil dChelsea Skin & Laser, New York, NY eChelsea Eye & Cosmetic Surgery Associates, New York, NY fSkin Associates of South Florida, Coral Gables, FL gSkin Care and Laser Physicians, Los Angeles, CA hBay Area Laser Institute, San Francisco, CA iMemorial Sloan Kettering Cancer Center, New York, NY jAllergan plc, Irvine, CA *Currently: SkinDC, Arlington, VA


BACKGROUND: The number of nonsurgical aesthetic procedures performed in men is growing rapidly. However, there are limited data on treatment principles and goals for the male aesthetic patient.

OBJECTIVE: To review the objective data available on male aging and aesthetics and to synthesize with expert opinion on treatment considerations specific to male patients.

METHODS: Expert advisors met to discuss anatomical differences in male versus female facial anatomy related to aging, facial treatment preferences in aesthetically oriented men, and current dosing data for facial injectable treatments in male versus female patients.

RESULTS: Symmetry, averageness, sexual dimorphism, and youthfulness are generally accepted as factors that contribute to the perception of attractiveness. There are differences between men and women in facial anatomy, concepts of attractiveness in the context of masculinity and femininity, and treatment objectives. A communication gap exists for men, as evidenced by the lack of information available online or by word of mouth about injectable treatments.

CONCLUSIONS: Approaches to aesthetic consultation and treatment should differ between men and women based on the fundamental dissimilarities between the sexes. Educating men about available aesthetic treatments and about the safety and side effects associated with each treatment, as well as addressing concerns about their treatment results looking natural, are key considerations.

J Drugs Dermatol. 2018;17(1):19-28.

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Men represent a small yet growing segment of aesthetic practices. In 2016, men underwent 1.3 million aesthetic procedures in the US, representing 8% of all procedures performed. Most (85%) were minimally invasive; of these, neurotoxin treatment was the most common, with 447,500 procedures reported.1,2 With more awareness of the safety and efficacy of injectables, these procedures in men increased 74% from 2000 to 2016.1 The ability to return to work immediately, without substantial posttreatment recovery time, makes minimally invasive cosmetic procedures popular among men.3 Additionally, more men understand that optimized treatments have a natural appearance and do not feminize their faces.4,5 Treatment motivation varies among men; recent studies show that men may seek treatment because they desire a more youthful or “less tired” appearance.6,7 Despite the rising popularity of aesthetic procedures in men, limited data are available to aid practitioners in understanding treatment preferences of the male aesthetic patient.This paper aims to synthesize the objective data available on male aging and aesthetics with expert opinion on treatment considerations specific to male patients.Anatomy of the Male FaceA broad range of sexual dimorphisms in facial anatomy have been documented and it is important to be aware of these differences when treating men. While men and women have the same facial musculature, men tend to have larger muscle

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