Dermal fillers for men. Are there any special considerations to keep in mind?

Hi yellowsubmarine,Men tend to have flatter cheekbones.  High cheekbones or apple cheeks can be a more desireable feature on women.  Filling the tear troughs of the lower eyelid and upper cheeks should add minimal to no volume to the cheek itself,  instead it is more about creating a smooth transition from the lower eyelid area to the upper cheek.  Depending on the fitness of the man, if the area directly under the cheek bone is very hollow, reducing amount of hollowness without making it full or puffy can also be helpful in creating a healthier appearance.Unfortunately, I do not have much before and after photos of male patients which consented to showing their photos online, although many did consent to showing them in the office in a private consultation.A good lower eyelid/upper cheek filling using Restylane should simply look like a well rested appearance, but not really add any chipmunk cheek appearance to their face.  Why?  Filling the lower eyelids and upper cheeks typically only requires 1-2 cc's of filler.  To give you a frame of reference, 1 cc is equivalent to 1/5th of a teaspoon (5 cc's).  2/5ths of a teaspoon will not make a huge difference in the masculinity or femininity of a face, but reducing shadowing on the lower eyelid and upper cheek will help in reducing the tired look.I typically will recommend that area first and let the patient get used to first cc or two of filler.  If they like the appearance and do not want any more, then they should stop there.  If they like the appearance and now notice other small shadows or concavities (valleys) to filler then they can use more filler to reduce those shadows.  Concavities are hollows, and hollows will cause shadowing on the face.  If a surface is flat or convex, then it cannot make a shadow.Some injectors will hear gaunt face and want to fill the "cheeks"  This can make the cheek prominences even more prominent while not filling the concavities which can make a face more "caracature-like" where caracatures typically exaggerate convex features like noses, cheeks and chins.Younger faces are more like a balloon where there are less shadows and a large majority of the area is very slightly convex which creates a relatively shadowless and young appearing face.Good luck on correcting your facial volume loss.Best,Dr. YangP.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

Hi @yellowsubmarine. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications.

Best of luck,

Dr. Nima

It’s no secret in the cosmetic industry that men are one of the fastest growing demographics. This comes on the heels of a menaissance, or a bit of a reverse sexual revolution where it is more acceptable for men to maintain their strength, power and youth. 
With what had been a rather small demographic growing rapidly, problems began to arise when old habits and knowledge of female aesthetics were applied to men, especially with less experienced practitioners. There’s a very specific sexual dimorphism that exists between male and female faces that keep a man looking masculine and powerful and woman looking feminine and beautiful. The process of aging is also different and man, with a more linear aging timeline that follows a steady testosterone decline. 
Male skin is thicker than female skin with less subcutaneous fat. The slope of the forehead, hairline and browline are much more important factors in men, and the nose tends to follow a similar slope to the forehead with little to no upturn at the tip, as opposed to a female faces. The characteristic flat, strong browline of a man square up with full temples to create the full facial shape of the upper face that is often described as squared.
The jawline and chin are often the most focused on areas for men, as they are traditionally the source of power and masculinity, but this needs to be balanced with the entire lower face, midface and temples to create that squared and balanced look.
One of the most common areas that I have to fix on man is the midface and eyelid-cheek junction, where men tend to have their volume more towards the middle of their face as opposed to the outside, which is a feminizing characteristic, but often during cheek augmentation volume is placed in a more feminine manner. In these cases I am able to adjust the volume to create a more masculine lid-cheek junction and balance with the rest of the face.
Some of my most common procedures performed on men include simple wrinkle relaxing injections with a neuromodulator, using volume to masculinize the face, improving the skin with laser resurfacing, hair restoration with platelet rich plasma, and eyelid surgery, which is a very stealth but very high yield surgical procedure to perform.
Some of the most progressive areas with respect to Maile cosmetics include improving post procedural results/recovery and hair restoration utilizing regenerative medicine such as platelet rich plasma and stem cells - check out my other articles for more information on thoseTo ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut
#realself100 Physician

Facial fillers are being used more often in men. There are a number of options for fillers. It's important to treat men differently. Women tend to look for higher, more rounded cheekbones. Fillers in men should be concentrated more towards the front of the cheek and in the mid-face area. Another very useful areas for me is to fill in hollow temples, that helps to soften the look around the eyes.

The brain reads feminine as being curved, soft and round, and the brain reads male when we see angles and sharpness, so we want to maintain those angles in our male patients. If it’s a first treatment, you want to start gradually, men don’t want a dramatic change.

Men often will complain that they look tired, and a lot of this tiredness is due to mid-cheek volume loss. Men lose subcutaneous adipose tissue as they age, but you also see this in men who are very fit and have a really low body fat content—giving you that drawn, sunken look. Filling this can be extremely refreshing. To avoid feminizing the face, you want to fill that loss rather than raise the cheek bone as you do in women.In men, volume replacement and volume correction and more important than lift. This requires deep placement of the filler. I don’t inject too much around the eyes because I find with men, you want to have some of those nice smile lines. If you make all of those go away, it tends to feminize the face. I use a smaller amount of toxin around the eyes and a larger amount in the glabella, because men tend to have a stronger glabella complex.

Fillers are for everybody. In general, the aging face is a common concern for most men. One of the top reasons men come to my San Francisco office is to address bags under the eyes and hollow upper cheeks. Though bags under the eyes may be your primary concern, the main issue is likely mid-face volume loss. Volume loss in the mid-face can cause the cheeks to look hollow and also increase that sunken look under the eyes.To address the upper cheek hollows, I usually like to treat the mid-face with Juvederm Voluma and the under eye area with Restylane. Although the process for treating men is the same as women, there’s absolutely no risk for feminization with my treatment plan. The only real challenge is finding a practitioner who can treat the under eye area with precision and expertise.Take a look at this video and our photo gallery for more information. Good luck in your search for information!

The aesthetic goal of fillers is to re-create the youthful shape of the face.  The youthful, male facial shape is very different than the youthful female shape.  Men tend to have square faces with sharp features and wider, flatter cheeks.  They lack full cheeks that result in the desired heart shaped, curved female face.  Because of the anatomical differences, filler placement in men is very different.  Fillers in the male cheek should be placed wider and lower while the jawline and brow are great areas to masculine male face.  To avoid feminization, I highly recommend seeking a physician who specializes in the aesthetic treatments of men.

There are many differences between the look you are trying to achieve in a man vs a woman and even some of the fillers I lean to are different.  Men have different facial shapes and generally thicker skin.  You should make sure to see a specialist who does a lot of injectible products and understands the anatomy and the different fillers and toxins.  Any experienced surgeon can give you a totally natural look and explain to you what they are trying to achieve as far as brow position, strength of the jaw line and chin, symmetry etc.  These nuances are all essential to get a masculine and youthful yet natural look.

The answer to your question is an emphatic yes.  i am seeing more and more men interested in Botox and fillers, as well as laser hair removal and skin tightening procedures.  In men, filler might be placed under the eyes, in the midface, along the jawline and temples. Men have a flatter face and more prominent jaw and brow, as well as a flatter brow, and it is important for most men to retain and emphasize these masculine features and not feminize the face by placing filler only in the high lateral cheek or over the zygoma, or in the lips. It is helpful to seek out a board-certified dermatologist or plastic surgeon who is an advanced injector with experience working with men.

One of the biggest considerations in replacing volume, especially in men, is that it appears natural.  I recommend Sculptra for my patients since it consistently gives the most natural results and tends to have little or no down time (unlike the other fillers which tend to bruise more).  For the best cosmetic results please consult a board certified dermatologist with experience in Sculptra.