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!
