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Tips for Treating Male Aesthetic Patients: Q&A With Dr Terrence Keaney

Tips for Treating Male Aesthetic Patients: Q&A With Dr Terrence Keaney

Thu, 01/30/2020 - 15:43

Dr Keaney

More and more men are seeking cosmetic procedures to improve their appearance and slow the aging process. In addition to anatomical differences, men have different concerns about how they look compared with women. Terrence Keaney, MD, discussed these concerns and trends among male aesthetic patients, and also shared pearls for treating this patient population at ODAC Dermatology, Aesthetic and Surgical conference in Orlando, FL.

Dr Keaney is founder and director of SkinDC and an assistant clinical professor of dermatology at George Washington University School of Medicine.

The Dermatologist: What are some common trends among male aesthetic patients?

Dr Keaney: Like broader trends in aesthetics, there is no cookie cutter technique for treating men. Gender is just one data point, albeit a fairly important one because it affects biology, anatomy, behavioral expectations, etc. When evaluating a new cosmetic patient, gender, age, ethnicity, and other patient factors play a role in creating a customized treatment plan.

Understanding aesthetic procedures among male patients has not been well-studied and has not been on the top of many aesthetic providers minds, most likely because men occupy a smaller percentage of cosmetic patients. However, the number of men seeking minimally invasive procedures is growing.

As more men seek cosmetic treatment, it is important that physicians and practitioners know how to approach these patients from a treatment perspective, as well as how to discuss complications from these procedures because these scenarios may be different compared with female patients.__________________________________________________________
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The Dermatologist: What are some of the differences between male and female patients that dermatologists should keep in mind?

Dr Keaney:  The number one difference between men and women is anatomy. Anatomy really dictates how a provider will perform a procedure, especially fillers.

The facial anatomy of men is very different than women. For example, the distribution of fat is different between the sexes. Men have less subcutaneous fat in the face, especially in the medial cheeks and middle of the cheek, and do not have high cheekbones, which dictates where a filler would be placed. The apex of the cheek tends to be lower and more towards the middle in men, whereas the apex tends to be high and lateral in women and is considered a very feminine feature.

Behaviors, such as goals and expectations of cosmetic procedures, differ between men and women as well. Men care about different factors than women. Specifically, men worry about 3 areas: the hairline, eyeline, and jawline. When discussing aesthetic procedures and performing a full-face analysis of male patients, I often refer back to these 3 areas because I know men tend to worry about them the most.

However, this does not mean I do not use fillers on the cheeks or the mid-face. When I use a filler, I explain to the patient so they understand how this procedure may influence how their jaw looks or their eyes look. Otherwise, they may not be interested in that treatment option.

Other major concerns among men include hair loss and body contouring.

The Dermatologist: What are some of the challenges for performing cosmetic procedures on male patients?

Dr Keaney: One of the biggest challenges is using dermal fillers and getting male patients to buy into the procedure. There is a psychological barrier that practitioners have to overcome in order to convince men to undergo filler injections because of the stigma around overfilled cheeks and big lips, which both tend to be viewed as feminine features. Practitioners have to explain that they are not going to feminize them, but will use the filler in a different pattern.

The second biggest challenge, of course, is to perform these procedures in a way that does not feminize the male patient who does not want to be feminized. The filler should be placed in the mid-face to create that cheek apex and build the mid-face without creating a lot of curves but instead more defined lines, which is more classic in men. Then, focusing on the lower face and creating a strong jaw if they do not have one are important steps.

In addition, achieving the right chin projection is important. The chin in men tends to be wider and has a more forward projection compared with women. There is a lot of nuance in using dermal fillers in men and in convincing them to buy into your treatment plan and to truly trust that you are going to give them the results they are seeking.

The Dermatologist: What are your recommendations for treating male patients? What are some common pitfalls?

Dr Keaney: It is important that practitioners, especially in the beginning when validating themselves in the eyes of a new male patient, speak with confidence and “hit the home runs” in the beginning by really treating the areas that men worry about the most in order build trust. As I said before, this means addressing the hair line, eye line, and jaw line and explaining how this will be accomplished.

One pitfall is using the same formula for a male patient as a female patient, especially when discussing fillers. For example, the cheeks, nasolabial folds, and lips are not major areas of concern among men. So, an important question is, how do providers use fillers in areas that men are more concerned about and how do they communicate that to male patients to get them to buy in?

I think part of the problem is men are a little less educated about aesthetic procedures compared with women. A lot of practitioners do not adequately educate their male patients on the risks and benefits and the rationale for doing a specific treatment because they are used to female patients who already have some knowledge about cosmetic procedures. Men often do not really know about aesthetic procedures and do not come in with a knowledge base about what these procedures do and how they work. How do you overcome that knowledge gap? It is important that practitioners spend time educating male patients on the scientific rationale and anatomic rationale for a procedure during the initial consultation.

In summary, practitioners should know the anatomy and where to place the product, know how men think about their face and their concerns, and know how to communicate treatment options based on not only male anatomy and concerns, but also how men perceive the procedure in order to ensure the best outcomes when strategizing a treatment plan.


Keaney T. Male aesthetics: Aging, masculinity, beauty, and treatment implications. Presented at: ODAC Dermatology, Aesthetic and Surgery Conference; January 18, 2020; Orlando, FL.

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