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About Face: The New Boom in Botox for Men

Today men are jumping on the cosmetic-surgery bandwagon faster than ever.

Recently, a 35-year-old entertainment exec went to see Dr. Babak Azizzadeh, a Beverly Hills facial plastic and reconstructive surgeon. He was there for one specific reason—and no, it wasn’t to look younger or more attractive. “Everyone thinks I look angry in meetings,” he said. “I don’t want to look angry.” What gave that impression: the vertical grooves in the center of his forehead—known as the 11s—which Dr. Azizzadeh attacked with Botox.

The number of male patients getting Botox has been hitting new highs in recent years—363,018 men in 2011, according to the latest figures—making it the most popular minimally invasive cosmetic procedure among men. as their numbers boom, what intrigues physicians is why this group is coming in. Women, still the vast majority of users, almost always rely on the toxin to knock a decade or two from their age. But guys are OK with showing their years—for instance, they leave their crows’ feet untouched. “Men with wrinkles there command more respect,” says Dr. Adam Kolker, a New York City plastic surgeon. so what are their priorities? “They don’t want to look angry, sad or tired,” Dr. Azizzadeh reports. And with the volatile economy and tight job market, high-achieving men are experiencing these feelings more than ever.

Dr. David E. Bank, a cosmetic dermatologist in Mount Kisco, New York, divides his male Botox patients into three groups. The youngest ones have grown up with procedures and see them as just a form of maintenance. Of the other two segments, he says, “There are the men who’ve achieved a level of success but who want to seem as energized as the guys nipping at their heels. and then there are the attorneys and bankers handling big deals and lawsuits. They want a look of calm so that at the negotiating table, they appear as if they can walk away at any moment.”

The main downside of Botox, of course, is its lack of staying power—it wears off after a few months. so physicians are also deploying fillers—the results can last up to a year—as a revitalizer. In men, one increasingly popular area for treatment is the tear trough. An injectible there can make dark circles and eye bags vanish, yet the effect is subtle. “After my male patients get it, their friends tell them they look great but they can’t figure out what’s changed,” Dr. Bank attests. Cheeks are another spot where a little filler can make a big difference. As we age, we lose volume in our cheeks—in men, this comes across as haggard and exhausted. Adding Restylane or Juvederm to the apples is a quick fix. Fillers do have one drawback; the injections can leave some bruising and swelling. Knowing this, Dr. Bank and others schedule the procedures for men on Friday afternoons. “By opening bell on Monday,” he says, “the marks are gone.”