Men are different than women!
You raise a very pertinent, and unfortunately oft overlooked, issue in aesthetic surgery - men and women are different! We should not have the same goals in mind or use the same techniques to inject or operate on our male patients as we do on our female patients. Males more often than not should be left a little "under treated" if anything to appear natural, as it is very easy to make them look done, bizarre, and over-feminized just by inexpert application of these procedures. This is no more true than in the cheeks and midface regions. Now, we must recognize that although tastes differ and are very individualized, most of the time men don't want the same fullness and roundness of the cheeks, upward slant of the eyes, or width of the midface that women do. Witness people like Bruce Jenner, Kenny Rogers, Burt Reynolds, Wayne Newton, and many others who have had obvious facial rejuvenation procedures leaving them looking un-natural, and in my opinion, feminized. If you look at their eyes and midface you will see that more often than not, that is where the problem mostly resides. Granted, there are some "edgy" appearing males, like David Bowie, who have sported high, sculpted cheeks, but they still looked masculine and natural. That is the challenge. When I am injecting males, I tend to focus more on blending the orbit-cheek junction between the eyes and cheeks, addressing hollowing of the eyes, brows and temples to give a more even, blended appearance. The same goes for the cheeks, and while I may wish to add some volume to the anterior malar region, or "apple," I won't add as much as I might for a woman. will also extend the augmentation of the cheek posteriorly along the zygomatic arch, or cheekbone, to create a more sculpted look there. In the submalar area, also called the midcheek, I think Sculptra works best, and I don't even use Voluma there. In that region we want to achieve a more even, diffuse thickening rather than a mass-like volume, and Sculptra in my hands is a wonderful tool to do that. It leaves a very natural appearance, it is very subtle, and it lasts about 2 years. There is so much more to discuss with regard to this issue of men and women, but these are the main things to consider, especially where the cheeks are involved. Just look at pictures of the men with remarkable facial structure that are currently the hot items in our culture and study their faces in detail - the Brad Pitts, Tom Cruises, Johnny Depps, Wil Smiths, Matthew McConoughys, etc, - and you will see it all right there. Best of luck!
Voluma is an excellent product that can achieve more "sculptural" effects than some of the other fillers. Because it is so elastic it essentially pushes and lifts the overlying skin as long as it is placed at the level of the deep tissues and bone. Men are very different from women and it is very important that you clearly express what you want to accomplish with your physician. Analysis of your anatomy and facial shape is necessary to individualize your treatment. Frequently, when a patient seeks re-volumization to treat the volume loss of aging it is handy to see old photos. These act as the blueprints to tell us where we want to go. Our goal is for a natural, subtle and healthy look - not to put you in witness protection!
Make sure you consult an
experienced board certified plastic surgeon, facial plastic surgeon or
dermatologist for your injections. If being injected by a certified
nurse injector make sure they have direct on-site supervision by one of these core specialists. It is
important to receive your injections from a qualified injector so any
possible complications (albeit rare) can be recognized and treated
appropriately. Best wishes.
Cheek augmentation varies in every individual. There is not a single formula for all men or all women. An injector with an artistic eye and experience in cheek augmentation will inject Voluma where it will best balance your face. That being said, men should not have too much injected in the lateral aspect of the cheek as this can feminize the face. More should actually be injected towards the front of the cheek (apple) but not so much as this too can feminize. Most men naturally have a flatter cheek bone than women due to less fat deposition so when augmenting the cheeks we want to maintain this natural balance.
Yes, where you place filler does depend on the gender of the patient, as well as the patient's original facial features. So in males, most of the time, I don't create "apples" of the cheeks and high cheek bones, as those are more feminine features. The filler doesn't have to be used in a 4 of these areas, that's just where it's approved for use.
"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."
This is an excellent question. Filling the space directly over the zygoma( the cheek bone) will accentuate the "apple" and will effeminize the appearance of a male patient therefore I agree with Dr. Hasen that Voluma should be placed at a more lateral position and at the lower border of the zygoma to broaden face not create a greater degree of anterior projection.
You are exactly right about where men need volume. The apple of the cheek and high lateral cheeks are feminine traits. So in men, I concentrate on widening the width of the cheeks, by placing Voluma on the zygomatic arch (the bone connecting the cheekbone to the skull)). Additionally, this is placed on the lower side of the bone, whereas in women I place the voluma on the upper side of the cheek bones to give a raised cheek appearance in women. This results in a masculine look rather than the treatment I do for women which tries to increase central cheek volume and higher cheek bones.