Male Aesthetics

Dr. Rattan:
So today we are talking about men’s aesthetic treatments, and I am with Dr. Sanjay, who has kindly given me his time. So I’m very excited about today. 
All right. So let’s get started. So, Dr. Sanjay, tell me the main things that people come in for, men especially.

Dr. Sanjay:
So with regards to men and aesthetic medicine, I guess a lot of people have got a lot of misconceptions and fears because when you really look into it, you’ll find things like Simon Cowell, and you’ll find things like-

Dr. Rattan:
Simon Cowell? Really?

Dr. Sanjay:
Yeah, yeah. A lot of people talk about him maybe overdoing it with Botox or maybe giving it a confusing name or people with either the whole Brotox movement, where people were getting overly treated. You could tell where someone looked a bit plastic-y and fake. That type of treatment plan is maybe what people associate with aesthetics. But having said that, I think with recent advancements over the last five to 10 years, the level of treatments that people can get now are just so much better, that the entire treatment plans for men is different.

Dr. Sanjay:
So generally, when people go to an aesthetic clinic, they might want to feel like they look better. That’s generally the purpose or reason why someone would go to such a clinic.

Dr. Rattan:
Freshen up.

Dr. Sanjay:
Yeah, exactly. With men, there hasn’t been too much guidance on what makes them look good. You always see things being marketed and things being pushed onto people about, “You need to do this, or you need to do that, and this is how you get good,” but there hasn’t been as much focus on men as there has with women, of course. With men, obviously there’s a lot of emphasis on staying in shape and going to the gym and that type of your life. But when it comes to your skincare regime or aesthetic treatments, it’s almost a little dark gray area that people don’t really talk about too much.

Dr. Rattan:
I totally agree. In fact, I went to dinner with my friends as a couple, and we were talking at the dinner table about our skincare routines as you do, because if you were at dinner with Dr. V, that is what we talk about. My friend, the guy, said, “Oh, I wash my face with hand soap.” I just thought, “Huh?” He goes, “Yeah, it feels really tight afterwards. It’s great.”

Dr. Rattan:
I was like, “No, no, no, no. The skin should never feel tight after you’ve washed it. That’s the number one mistake.” So instead of sending him a case of wine, I sent him a case of my [inaudible 00:02:40] jaw wash, and so now he has supple skin. But until that point, he thought stripping your skin was the way forward.

Dr. Sanjay:
Yeah. Even before then, before I even went to medical school, before I knew anything about skincare, every guy know would probably use a really rough apricot scrub once a year.

Dr. Rattan:
Yeah. St. Ives, yeah? Once a year?

Dr. Sanjay:
They’ll be like, “You know what? I’ve got to have my scrub. I feel like I’ve got great skin now.”

Dr. Rattan:
I’ve had my scrub.

Dr. Sanjay:
I think that’s the limit for most guys.

Dr. Rattan:
Oh, my goodness. Oh, my goodness. Okay. Do you feel like it’s changing or do you think that women just talk about it more? So that’s why we could look at social media and think, “Oh, okay. So this person does this with their skin, and these are the treatments that they’ve had done,” but men maybe are not so open about what they’ve had done? Would do you think?

Dr. Sanjay:
I think it’s a case that times are changing. I think with each passing year, men are getting more interested in their skin because I guess they’re seeing that it is something that can be improved, and if they can improve it, maybe it changes how they feel about themselves. Maybe they’re more confident. Maybe they’d like to have better skin, and it’s something they notice more now than they did before. It could be down to something as simple as the quality of cameras are just getting better every single year. Aren’t they? These things are getting-

Dr. Rattan:
So the definition on your face is seen more?

Dr. Sanjay:
Almost. It’s like people are seeing themselves really in HD, and they went before.

Dr. Rattan:
Wow.

Dr. Sanjay:
Maybe that level of analysis is happening now that wasn’t previously.

Dr. Rattan:
Yeah, and that’s a bit scary.

Dr. Sanjay:
It is potentially. Yeah.

Dr. Rattan:
Yeah. Then you’ve got Instagram, which just doesn’t help the situation. Does it?

Dr. Sanjay:
No.

Dr. Rattan:
So what sorts of treatments do you think men tend to opt for?

Dr. Sanjay:
So with men and aesthetic medicine, a lot of the focus is in the lower face. So the areas that typically most men are going to probably look to tweak, if anything at all, is going to be focused around the jawline and the chin and tightening up that whole area. As to why that area is the good area to focus on, we’ve actually done an article with [inaudible 00:04:29], a Cambridge professor who specializes in evolution. He basically did an interview with us where he was explaining the link between testosterone, immune systems and square jawlines. So for men to look better with a square jawline, a lot of people think, “Well, why does a square jawline look good? Why is that something desirable?” It’s because there’s some evolutionary triggers that make it attractive traits to have, because it almost symbolizes things like … things relevant, rather, to your immune system.

Dr. Sanjay:
So for these reasons, it’s science-based, it’s evolution-based as to why a square jawline is more attractive. For a male face for example, if I were to see a patient, the emphasis of the treatment might be to create a little bit more jaw width for it to match maybe from inside to a bit more outside and to square off their jaw if it’s a bit more narrow. Or there’ll be a focus moreso on the actual angle itself. So with men, you want a bit more of a harsher angle to create that more chiseled look.

Dr. Sanjay:
Then you’ve got the male chin. So with regards to a strong male chin that people always talk about, you look at the width of the lips. So is the man’s chin fooling within the width of their lips?

Dr. Rattan:
Okay, so like this way?

Dr. Sanjay:
Yeah, precisely. So with a male chin, you want it to be a bit wider, compared to a female chin, for example, where you look more at their nostril width. So for a female chin, whenever we’re looking or assessing a female chin, our markers are a little bit different for what looks attractive.

Dr. Rattan:
Where do these ideas about attraction and geometry come from? Who assesses this and how … ? I’ve never understood that. How do people assess that the lip should be narrower than the chin? How’s that?

Dr. Sanjay:
Yeah. This is precisely it because when people say things like, “Oh, you should have a strong chin or a good jawline,” where does this idea come from? Because it sounds like it’s something that’s almost forced on men. But that’s what the science says because the science studies the evolutionary trends and traits, and it explains as to why people with strong jawlines have been seen as attractive because they’re the ones who’ve had the signals between testosterone, a square jawline, and a strong immune system. They have ultimately passed on their genes as an attractive trait. So it comes from the idea of evolution, that the strong jawline is something that people are attracted to physically.

Dr. Rattan:
Okay. All right. I understand that. Okay. Right. So I think the other area that men probably come for a lot is under eye hollows and volume loss. Is that correct?

Dr. Sanjay:
Yeah. So I guess with dermal fillers, broadly speaking, there are two different types of treatment plans. So on the one hand, you’ve got your enhancements or your tweaks. So these are going to be more things like if someone doesn’t have a strong jawline and they want to create one, this is something we can do with respect to their anatomy and something that we can improve. We are fundamentally changing the way someone looks.

Dr. Rattan:
Okay. Which options then would you use for that?

Dr. Sanjay:
So before we get started, with this type of treatment, this is more of an enhancement, right?

Dr. Rattan:
Right.

Dr. Sanjay:
Then you’ve got more of a rejuvenation or restoring treatment. That’s more where under eyes will fall into the category of.

Dr. Rattan:
Yes.

Dr. Sanjay:
So for male faces as well, as part of the aging process, we start to lose volume in a pattern, which is consistent for men and women. We lose volume in a consistent pattern. One of the areas where we have a bit of volume loss and in our mid-cheek. As we have volume loss there, we can also get some hollowing under our eyes as well, because it’s associated with the aging process.

Dr. Sanjay:
For under eyes in particular, there’s an aging component and a genetic component. Some people genetically, even 18-year-olds, could have deep sunken eyes. You can see it sometimes where you can see they can have dark circles. They can have a big groove in their tear trough, and it’s a genetic issue more than an aging issue. So for under eyes in men, it can be genetic. It can be an aging issue. But the good thing is that both of them can be treated because these areas that we treat really, really commonly just to refresh and restore to the under eye.

Dr. Rattan:
So that all makes perfect sense. So in terms of where men go to get aesthetics done, what type of fit is your favorite for the jawline and for under the eyes?

Dr. Sanjay:
That’s a good question. So I always tell every new patient particularly, I always tell everyone to really research everything as much detail as you can before you ever get anything done. But I think the aesthetic industry, particularly in the UK, is really scary for a patient because there are 150 different brands of dermal filler. They all say that their the best, but really when it comes down to it as a doctor, as a medical practitioner, we like to ask the brands, “What’s your research? What’s your evidence base? Where are your outcomes? How long have these products be used for? What’s your manufacturing process?” The entire history of a product almost, before it gets into your hands, because there are new dermal filler brands popping up every other day.

Dr. Sanjay:
With the best quality brands and fillers, these are the ones that are going to be coming from a medical pharmacy. They’re going to have loads of research behind them. They’re going to integrate really nicely. They’re not going to lump and clump anywhere. They’re not going to migrate. They’re going to last a really long time. So the spectrum of fillers from one end to the other, there’s a huge spectrum. But then even within good quality fillers, you get different types. So for a jawline or chin, for example, you might want to use on this quite thick, that’s going to project.

Dr. Sanjay:
So if you’ve got someone who’s got a narrow jawline, you want to build out width using something quite thick. But then for the actual angulation of the jawline, you want to use something a little bit thinner, that’s going to integrate with more of a dynamic feel to it. So you want one that’s going to be able to express with the guy when he’s laughing, when he’s talking, when he’s moving. We don’t’ want it to look like a golf ball that’s stuck on the side of his jaw.

Dr. Rattan:
Yeah. That’s not natural.

Dr. Sanjay:
It needs to let natural. I always tell any male patient who gets their jawline done, when you feel it for the first three to four weeks after treatment, it will feel, to you, a little bit like you’ve got chewing gum stuck under your skin. It feels like that. It doesn’t feel natural. It’s not painful or anything like that. It just feels a bit strange. But then after about four weeks, it starts to integrate with your own tissue. It just feels like part of you. So that’s the intubation process for a good quality filler.

Dr. Rattan:
So it’s two different fillers for the jawline?

Dr. Sanjay:
Yes.

Dr. Rattan:
Okay. That’s really interesting. Do you build it up over time or is it just all done at the same sitting?

Dr. Sanjay:
I can be done in different ways. So I always say if somebody has never had the treatment before, we should always start subtle, using as little as possible to try and get the result we want, because we can always build on top of it and add more. If you get too much or you go for too much too soon, you can create something that maybe isn’t what you wanted. So by starting subtle, you can always increase more. By having too much, you can go too far the other way.

Dr. Sanjay:
So as a general philosophy, it’s always best to start subtle. Even with the under eyes, for example, we use a different type of filler, which is even thinner because under your eye, you’ve got less than you’ve got in other areas of your face. You’ve got skin, you’ve got muscle and you’ve got bone, but you have barely any fat under your eye. So it’s a very unforgiving area because if you use something a tiny bit too thick, you’ll see it straight away.

Dr. Rattan:
Wow.

Dr. Sanjay:
So even with product choice for the under eye, the formulation is completely differ.

Dr. Rattan:
Okay. So which ones are your favorite? Have you got specific ones that you love or do you like to play with different types of fillers?

Dr. Sanjay:
Yeah, so certainly the brand, the filler, that we like in our clinic is Teoxane, and we use a lot of Juvederm as well. These are brands that are industry leaders when it comes to research, when it comes to patient outcomes and the science and sophistication and technology behind the filler. This is what we like, and we’ve used it for many years. It’s something that longevity-wise, integration-wise, natural look-wise, it gives us exactly what we need.

Dr. Rattan:
Okay. Interesting. Are there side effects that we should be thinking about when it comes to fillers under the eyes and the jawline, or things that we should be thinking about specifically for men that don’t affect women’s [inaudible 00:12:44]? Is there anything that’s men-orientated in terms of side effects?

Dr. Sanjay:
So when it comes to side effects for treatments, the main one’s going to be immediate ones. For example, a little bit of bruising and a little bit of swelling. It can settle down pretty swiftly. With male treatments, they’re not high risk ones with bruising and swelling. So it’s a sort of treatment where if you got a treatment today, you can go to work tomorrow. People aren’t really going to notice much of it anyway, and it’s going to integrate over three to four weeks. So it’s not like lip fillers, for example, where the swelling profiles are a little bit different, where they can swell quite a bit on days two and three. With male treatments, there’s less swelling and less bruising.

Dr. Sanjay:
With regards to things like risks of treatments, a lot of people think, “Well, if it’s in the jawline, what can go wrong?” because the things that people worry about in the industry are things like blindness. This is what you look at when you read online. Am I going to go blind? It’s easy to think, “Well, the jawline is nothing to do with your eyes,” but actually anatomically speaking, your blood supply for your face all comes from where? Your heart. So as a supply traverses up, it goes through your jaw and supplies most of your face.

Dr. Sanjay:
So if you use poor technique or if you use a poor product, or if something goes wrong in the jawline, it can be really, really serious. But that comes down to the way that it’s done, the technique, the product used. Most importantly, if something goes wrong, recognizing it and managing it because with medical treatments, it is possible for things to go wrong.

Dr. Rattan:
Yeah, no, absolutely. Right. Is there anything that people … men should think about before they get aesthetic treatment done?

Dr. Sanjay:
So I always like to ask men, “Why do you want to get this treatment done?” Because I think it’s important to explore the psychological component of the treatment. If you’re ever thinking about changing the way that you look in any way, there should never be a knee-jerk reaction. It should always be something that’s quite well-thought-out and there should maybe be a history of thought process behind it. It’s not really a decision that someone makes on a whim, for example.

Dr. Sanjay:
Then another thing is I think everyone should just really research as much as they possibly can, where they’re going to go, and find out as much as they can, because the more information you know prior to a treatment, the happier you’re going to be fundamentally, because so long as you understand your treatment plan, you’re going to be happy.

Dr. Rattan:
Yeah, no. I absolutely agree. In fact, one thing I always think is, actually with any treatment, even when I had my rhinoplasty done or just any aesthetic treatment, I usually look at numbers, number treated by that person or by that clinic, because it just gives me a good indication as to, is this something that someone’s doing part-time or is this something that they are doing full-time? At that point, you know you’re treating thousands of people and so you know the nuances of that particular treatment. So I think that’s a really important question to ask actually, and to know about your practitioner.

Dr. Sanjay:
Yeah, definitely. I think one more added thing that’s interesting with male patients compared to female patients is men actually spend more, which you might not expect.

Dr. Rattan:
Really?

Dr. Sanjay:
Indubitably, yeah, because with female treatments, sometimes they might get little tweaks, like a little bit of lip filler, or a little bit of cheek contour or something quite subtle like that. If a male wanted to change the way their lower face looks and if they wanted to add jawline width and jawline angulation and build width in their chin and masculinize their face slightly with their features, we’re talking about a bit more of an extensive treatment plan. So with male faces, often it can be more. The men that come will probably get a little bit more done, and in terms of the number of men coming, it’s increasing,

Dr. Rattan:
What percentage would you say of your client are men versus female?

Dr. Sanjay:
So I’d say about five years ago or so it was 90, 99% female.

Dr. Rattan:
Really?

Dr. Sanjay:
So it was quite rare for us to see a male patient. Over time, it’s definitely changing. Now, in a usual clinic day, I’ll usually see one or two men every day-

Dr. Rattan:
Out of?

Dr. Sanjay:
Out of about 10 to 12 patients.

Dr. Rattan:
Oh, right. So that’d be 10% almost.

Dr. Sanjay:
Yeah, yeah. So, easily, we’ll see at least one or two patients who are men, but that’s not how it used to be.

Dr. Rattan:
Okay. When men get jaw filler done, how often do they have to redo it to maintain?

Dr. Sanjay:
It’s a good question. So again, this comes down to the quality of product used. So with dermal fillers, there’s a huge spectrum and the best quality ones, you’re looking at longevity that’s going to last about 22 months or so.

Dr. Rattan:
22 months?

Dr. Sanjay:
Yeah.

Dr. Rattan:
Oh, wow. Okay. So two years?

Dr. Sanjay:
Yeah. Typically I say to patients, “They’re going to last you 12 to 18 months” because I like to temper expectations a little bit. I’m genuinely expecting around 18. The manufacturers say 22, but I’ll give them the range of 12 to 18. Things that are going to impact it are going to be if they’re people who use a lot of sunbeds, if they’re people who smoke, if they’re people who are professional level athletes. Things like this can speed up the metabolism and speed up the breakdown of products. But generally speaking, with the best quality products, you’re looking at 12 to 18 months, closer to 18.

Dr. Rattan:
Okay. Interesting. Thank you very much for your time, Dr. Sanjay. I really appreciate it.

Dr. Sanjay:
My pleasure.

Dr. Rattan:
We’re all going to be in the conversation for one hour at the launch of this video. So please, if you’ve got any questions, if you’re a man thinking about getting aesthetic treatments done, and you really don’t know who to go to, please do write your comments down below. I know that Dr. Sanjay will be there to respond.

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