July-August 2012 | Features in Bethesda Health


When it comes to cosmetic procedures, more and more men are crossing the lines

Don is a 63-year-old Gaithersburg resident with a secret: For the past decade, he has been visiting the Bethesda office of plastic surgeon Roger Oldham two or three times a year for Botox injections into his forehead.

Think of it as “Boytox”—or as some wags are calling it, “Brotox”—a growing trend among men.

For Don, it all started when co-workers and even his wife kept misinterpreting his expression. Blame their confusion on his appropriately named “frown lines.”

“I had kind of deep wrinkles between my eyebrows that were really giving people the wrong impression as to what my mood was,” says Don, who asked that his last name not be used in this article.

When he was relaxed, his wife occasionally would tell him he looked uptight and worried. When he was content, co-workers sometimes would tell him he looked upset. “I didn’t want people to feel uncomfortable with me,” Don says. “I found that having this Botox treatment helped in terms of that erroneous nonverbal communication.”

He likes the look of his forehead so much that he has been thinking of having a little work done on the rest of his face. “There are times when I think I could benefit from just a general face-lift or a neck-lift,” Don says. “I’ve been kind of toying with that a little bit. I’m 63, but I don’t feel 63. I’d like to stave off the inevitable aging process.”

You might say Don is a trendsetter. In 2011, one out of 11 cosmetic procedures, or about 1.2 million, were performed on men, according to the American Society of Plastic Surgeons. Women still represent the vast majority of patients who undergo cosmetic procedures, both minimally invasive, such as Botox, and surgical, such as face-lifts. But men, notorious for avoiding doctors of all kinds, are making inroads in certain procedures.

For example, treatments with Botox or Dysport, its newer competitor, totaled 363,000 in men in 2011, an 8 percent increase over 2010, according to the plastic surgeons’ group. Injections were also up in women, but only by 6 percent.

The average treatment costs $500, but that varies depending on the number of injections, the expertise of the person administering the shots and the location of the office, according to the plastic surgeons’ society.

Also in 2011, men accounted for 18 percent of microdermabrasion treatments, which use tiny crystals to exfoliate dead layers of skin and minimize the look of fine lines. Use of microdermabrasion by men has nearly doubled since 2000, to more than 165,000 treatments in 2011, but it has fallen 5 percent for women during that time. Another popular minimally invasive cosmetic procedure in men is laser hair removal, with 186,000 treatments in 2011—up 13 percent from 2010.

When it comes to cosmetic surgical procedures, it’s “chin up” for men. Just over half of the 20,680 chin implants performed in 2011 were done on men, a 16 percent increase over 2000. Among women, the number of chin implants performed last year represented a 43 percent drop from 2000.

“Aesthetics or beauty is not something that’s the sole domain of women,” says Chevy Chase plastic surgeon Monte Harris.

Men’s motives for consulting with a plastic surgeon tend, however, to differ from women’s.

“Men are doing it because they’re competitive,” says Dr. Michael Olding, chief of plastic surgery at George Washington University. They’re competing for jobs, he says, and they’re competing for the available women. “You can almost always make some minor improvements. The question is, is it worth it?” In other words, will the patient’s attitude and personality match a more youthful appearance?

About 15 percent of Oldham’s cosmetic patients are men. Some, like Don, come in with specific ideas about what they want to fix, the doctor says. Others know only that they want to look more youthful. “They should talk to a board-certified plastic surgeon and discuss what features concern them,” Oldham advises.

In the Greater Washington area, Georgetown University plastic surgeon Stephen Baker and his colleagues “get a lot of government workers who can retire in their early to mid-50s. They feel good, they feel energetic.” They want to launch second careers, Baker says, but they’re often up against men a decade or two younger.