When it comes to consults with men, what issues are of the greatest importance?
Male and females display distinct anatomical variations, specifically in regards to bone structure and prominence, skin thickness, fat distribution, and muscle mass from the face down to the trunk and extremities. In regards to aging, men will experience greater periocular facial changes, more severe wrinkles, hair loss, patterned abdominal and truncal fat deposits, and gynecomastia, making them appear older than their actual age and their female counterparts.
It is also important to appreciate significant behavioral differences between male and females. In general, males tend to expose themselves to more external risk factors over time that include sunlight exposure, pollution, cigarette smoking, repetitive muscle movements, and oftentimes, poorer dietary habits and foods. Unfortunately, men tend to smoke more than their female counterparts, expose themselves to UV radiation, and less likely than women to apply physical and chemical sunscreens nor practice sun-protective behaviors.
Physicians need to be more cognizant of these gender-specific differences in anatomy and behavior in order to assess the male’s goals and expectations. Typically, males wish to appear younger and healthier, while also maintaining or enhancing their masculine features. However, there may come a point at which the degree of aesthetic goals becomes too feminine or masculine and may be undesirable to the male patient.
Within the male market, the gay male patient may tend to be more critical and sophisticated about their appearances and have possibly researched extensively possible injectables, non-surgical and surgical procedures than straight men. Another emerging market focuses on the needs of transgender patients. Physicians treat them as they would with any other patient with kindness, compassion and sensitivity to their emotional and psychological needs.
How does the consult differ when compared with women?
Traditionally, male aging is seen by them as being more gradual and more accepted than in females. Oftentimes, males refer to their wrinkles as manly character lines and interpret their greying and receding hair as making them more distinguished. Today, however, more and more men take pride in enhancing their appearance and physique. The demand for male-focused cosmetic procedures has increased because of shifting social attitudes, improved professional competitiveness, new trends in fashion, and the attainment of an idealized self. Even men in their late 20s and 30s, who wish to look more attractive to their spouses or significant others’ embrace non-surgical procedures and usually have no qualms talking about their choices. The main motivation for men undergoing cosmetic procedures was either the pursuit of a more youthful appearance or to just look better for their age without compromising their masculine appearance. More men are seeking masculinization of their face with stronger jawline, chin, and nasal profile with injectables and non-invasive devices, as well as reduction of submental fat with CoolSculpting® or Kybella®. For men, some of the main discouraging reasons for undergoing cosmetic procedures were cost, time for appointments, or recovery. Of concern is whether the increased demand is a passing trend or a lasting norm.
As men differ both in their anatomy and goals, clinicians are required to specialize their approaches, treatments, and techniques accordingly. As aesthetic plastic surgeons, we should provide safe and effective treatments that spans the spectrum from basic FDA-approved skincare regimens, neurotoxins, dermal and subdermal fillers, chemical peels, fractional laser resurfacing, non-invasive device procedures, and if indicated, minimally-invasive procedures to surgery. Commonly, combined approaches may be advised to obtain the desired results and recovery times that meet realistic expectations and costs. Highly qualified board-certified practitioners should be able to deliver subtle, natural results with safety in mind, so that family and friends can comment how well the procedure was done.
What brings men in for treatments? (spouse referrals, external marketing, etc.)
The main motivation for men undergoing cosmetic procedures is either the pursuit of a more youthful appearance or to just look better for their age, but still maintaining a masculine look. In my practice, referrals from a patient, spouse and partner are the most common sources and resources, while other influencers such as external marketing from social media and website, and a competitive workplace, continue to be important.
Please describe successful approaches in managing expectations of men versus women?
Managing the expectations of surgical and non-surgical procedures always begins with an informed consent that includes a frank discussion of their motivation for seeking improvement of their aesthetic concerns. They must undergo a detailed examination of their anatomical findings and come to some understanding of what can realistically be accomplished by the proposed non-invasive or surgical procedure. They must comprehend the steps of their individualized treatment protocol, possible adverse reactions, and recovery time. They must understand that what they wish to accomplish and what can be accomplished depends on a number of factors that may be beyond the provider’s control. Always under-promise results and try to achieve over-expectations. A number of consultations may be necessary. Do not be uncomfortable of saying that you may not be able to deliver what they wish and that they may wish to have a second opinion.
A growing trend has been to use before or after micro-approaches to maintain the aesthetic results. The concept of “less is more” philosophy of in the use of neurotoxins like BOTOX® Cosmetic and fillers whose duration of effects may be shorter, but provides a continuum of results.
For example, a novel microneedling device has been developed to directly deliver FDA-approved drugs by tapping its short and fine solid needles into the dermis. Its empty chamber may be filled with a cocktail of neurotoxin, H-A filler, and Sculptra, and even PRP and regenerative nanofraction cells for skin rejuvenation and hair stimulation. Non-surgical rhinoplasty, also known as “nose filler,” is becoming popular amongst women, as well as men. The treatment has been popularized by social media influence as a quick and easy treatment with little down time. It can be used to lift the tip, smooth out any small bumps or curves to improve symmetry. A recent trend is to avoid overfilled lips but to achieve enhancement of the shape of the mouth and face by different new dermal fillers. The use of gel filler can be used to lift the skin of the face, reduce folds and wrinkles and define facial contours for a more youthful appearance. The use of new HA filler along the lip lines and body of the lip along with neurotoxins has been used to achieve a more prominent pout. Thread lifts are also returning for minimal-invasive elevation of facial fat and skin from improved technology and effectiveness.
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