If you are a man wondering what can be done to restore your youthful looks, you may not know where to begin. Regardless of your age, there is a good chance that you do not have many guy friends who have had facial rejuvenation treatments (or they are not outspoken about it). Without the guidance of a friend or close acquaintance who has already navigated through this territory, it may seem too foreign to consider, or too complicated to approach. One might even mistakenly draw the conclusion that face or neck rejuvenation is restricted to women because that is generally what we are exposed to in popular culture and media outlets. However, we are now seeing more men than ever seeking out the fountain of youth that so many women have tapped into. This makes sense because the results of aesthetic treatment can be incredible (and why not for men too?), there is an ever-enlarging array of options to suit almost any man’s age and treatment goals, and because of the potential career-related benefits.
If you went to the Facial Rejuvenation restaurant, the menu would include various items to target different aspects of the aging face and neck. As a man, you would likely order from the menu a little differently than a female guest, and your dishes would be prepared a little differently. For example, men may be more interested in menu selections that target rejuvenation of their hairline, eyes, and sagging neck, whereas women may be more concerned about the impact of aging on the shape of their lips, brow, and cheeks. As an entrée, a face and neck lift is the most powerful approach to reduce unwanted jowls and skin laxity of the face and neck for both men and women, but the execution tends to differ. For example, in men, the facelift incisions around the ear must be designed properly to avoid displacement of the hair-bearing skin into unwanted areas, while remaining very well camouflaged. In the male neck, it is more likely that contouring of muscle and the deep neck contents will be necessary to restore a chiseled jawline. In many cases, a facelift may not be needed at all, and a well-executed neck lift may be the perfect solution.
Maintaining and enhancing masculine features is of highest importance for male facial rejuvenation. Many of the facial features that determine masculinity are related to bone structure—a prominent brow, a strong jaw, and chin. This facial skeletal structure is preserved in any male patient, but it may even be enhanced or augmented if desired with a variety of techniques. When the soft tissues of the face are re-draped over this bone structure with a facelift, the shapelier appearance of youth is revealed. For men, this tends to be a more square, angular facial shape with a strong jaw profile. Women on the other hand usually prefer to see a ‘heart’ shape (somewhat wider around the temples, and a slim, tapered jawline). If undergoing a male brow lift, it is critical to maintain a relatively flat eyebrow shape positioned over the superior orbital rim, as opposed to women who often seek to restore a higher, arched position and shape. These differences may seem like fine technical details, but they make all the difference.
For younger men, surgical rejuvenation options may not be necessary at all. Nevertheless, skin ages relentlessly, especially with sun exposure and other lifestyle factors. Creases in the skin may seem to be more permanently etched in with every facial expression. As early as our 20s and 30s we may notice skin laxity and our once-chiseled appearing facial structure becoming obscured by skin laxity and subcutaneous fat. Luckily, an armamentarium of non-surgical, non-invasive, and minimally invasive methods to halt or reverse these issues is at our disposal. Botulinum toxin is increasingly popular among young men to keep the skin smooth and wrinkle-free. Radiofrequency energy treatments to the skin help to restore elasticity and keep it tight over the masculine bone structure. Laser therapy and intense pulsed light (IPL) can help with discoloration (solar lentigo or sunspots) and acne scarring. Like compounding interest, small investments made in your face now will become much more valuable as you get older in years.
Male Facial Implants
Some men are lucky enough to develop the chiseled features of a Greek god in their teen years, but most of us mortals need to put in some effort to achieve the look we desire. If you weren’t endowed with the cheekbones of Adonis, or don’t have a jaw that looks like it was sculpted from marble, you may have wondered what it takes to attain the manly features you see that inspired artists like Michaelangelo. That je ne sais quoi can generally be summarized in two words: bone structure.
Facial implants are the ideal way to augment the face’s natural bone structure to create a more masculine, sculpted appearance. Implants are so straightforward and elegant that they are arguably the greatest aesthetic hack ever devised for men. Facial implants have all of the qualities of an ideal surgical procedure:
1. Reliable results
2. No visible scars
3. Precision (size, shape, customizability)
4. Durability and permanence (but reversible if needed)
5. Minimal downtime
6. Low risk
The most common areas for men to augment are the jaw and cheeks. In general, the goal is to create a more defined facial structure and to improve upon the proportions of the face. Just like artists and architects throughout history have used the Golden Ratio to create beauty in their masterpieces, the proportions of the face can be analyzed from a surgical perspective to determine where deficiencies can be corrected. In the cheek, for example, the width of the cheekbone, projection of the cheek, or both can be augmented with implants. For the jawline, the chin can be augmented, and the mandible can be widened, or vertically lengthened at the jaw angle. Determining what is best for you depends on your facial analysis. Here are some desirable traits for the jaw that you can check out in the mirror, or check out on one of your favorite jaw models—think actor Henry Cavill as an example.
On anterior view:
1. The jaw angles sit well below the ear and approximately in line with the oral commissure (corners of the mouth) when your head is level
2. The bigonial width (the width of the jaw at the angles) is just slightly less than the bizygomatic width (between the cheekbones)
3. The angles of the jaw (soft tissue gonions) should project beyond the tissue planes of the neck
On profile view:
1. The vertical part of the jaw (ramus) should be visible and form a distinct angle with the body of the mandible
A couple of questions generally arise when speaking with patients about implants. Firstly, why not use filler for augmentation? It seems to be much more popular after all. Fillers are being used in the lips, nose, and cheeks—anywhere you can think. There are a few good reasons why implants have superior qualities over fillers. They are permanent. They are perfectly symmetric. They are solid and behave like bone. They feel like bone. More important, they look like bone. They do not migrate or dissipate over
time. There is a reason the statue of David was sculpted from stone and not a gelatinous substance. The same goes for your jaw and cheekbones. Generally speaking, fillers are good for volumizing soft features, whereas implants are good for volumizing solid features.
The second question is whether preformed or custom implants are preferred. This depends on the individual patient. Custom implants sound attractive because they are personalized and precise—which they are—but they come with additional expense and steps. For most patients, the variety of preformed implants in different shapes and sizes allows us to bypass creating a custom implant. At the end of day, like commissioned artwork, the surgical process is tailored to your exact desires to achieve the look you want.
