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

I'm a mid-30's man, considering dermal fillers for facial volume loss -- most likely caused by a fairly intense exercise regimen. My biggest issues are sunken eyes and hollow upper cheeks. I'm still doing my research, but was just wondering if there are any special considerations for male patients to keep in mind? (E.g., since most patients are female, is there anything I should keep in mind to avoid a "feminine" look? Are there any typical injection "mistakes" made with male patients?)

Doctor Answers 13

Fill the valleys and not the peaks

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. Yang

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New York Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Dermal Fillers for Men

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.

Sherry N. Ingraham, MD
Katy Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Juvederm Voluma for Mid-face Volume Loss in men

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!

David C. Mabrie, MD
Bay Area Facial Plastic Surgeon
4.5 out of 5 stars 74 reviews

Fillers in Men requires careful consideration of Male Facial Anatomy

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.

Terrence Keaney, MD
Washington DC Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Filler in 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.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.5 out of 5 stars 51 reviews

Filllers in men

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.

Sheryl D. Clark, MD
New York Dermatologist
5.0 out of 5 stars 7 reviews

Facial fillers for men are placed differently than in women

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.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 95 reviews

Dermal filler and replacing facial volume in 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.

Men and fillers

In my experience with men, I don't try to fix every wrinkle. Men should have texture to their skin. I also find that I inject the filler much deeper to get a more natural skeletal enhancement rather than skin plumping. I don't think most men should have their lips filled or the corners of their mouths. Its all about turning unflattering shadows into youthful looking highlights. With men its more about creating angles and sharp features; whereas, in women its about creating a smooth inverted egg appearance of the mid face with minimal sharp edges.Ultimately, you need to know what you want and convey your expectations to your doctor and ask if they can achieve it. Most will have too big an ego to say no. Thats why its called "trial and error". Its not a big problem. It can be fixed if its not what you had in mind. Sometimes a new hairstylist gets it right the first time and sometimes they never do, but most get it right after a couple of tries. No matter how much we want to make it into an exact science, its an art performed by artisans and technicians of varying skill and experience no matter what their specialty.

Edwin Ishoo, MD
Brookline Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

More re. fillers for men

I agree wholeheartedly with Dr. Ibrahimi's advice, to seek a core cosmetic specialty physician and one that can discuss how they will avoid feminizing and maintain a healthy, young masculine look.  To be more specific, some mistakes that are made that can over-feminize men and should be avoided are; placing too much filler in the cheeks alone and not balancing it out with some filler in the jawline as well, lifting the brow too much with filler or Botox, and filling the lips too much. 

Karen Stolman, MD
Sandy Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.