The best Injectables Treatments for Men: navigating the ‘Brotox’ Boom

AUTHOR - DR. DAVID JACK

Over the last few years, the number of men coming for treatments in my clinic has increased significantly. When I first started doing injectables about 16 years ago, only a few patients were men - now, the proportion of men to women is about 30% men, from all sorts of backgrounds. The same goes for skincare - we used to see very few men who would even use a cleanser, let alone the all-important daily sunscreen (the incidence of melanoma in men has increased by around 300% since the 1990s) - men are thankfully starting to become more savvy about skincare use. Since I wrote my book ‘Vain Glorious’ about men’s skincare and treatments with Jeremy Langmead , I’ve noticed that men who’ve read the book are much more comfortable having tweakments with the knowledge they are not going to look strange!

There is a little bit of a misconception that men are less concerned with ageing vs their female counterparts - I personally don’t believe that this is true, given the huge increase in men coming for non-surgical treatments in the last decade or so. Undoubtedly, I’ve seen a rise in enquiries from men as a result of their wives being the first adopters of aesthetic treatments, however, more and more men were seeking skin treatments through social media. It’s difficult to know exactly why this might be - men almost always lag behind women with certain consumer behaviours, but I think a change in social judgement of vanity in the last few years has certainly fuelled an increase in the number (and demographics) of men attending clinics for non-surgical treatments.

Why are more men doing tweakments and ‘Brotox’ these days?

With its ability to shape societal attitudes, social media has played a pivotal role in encouraging men to explore and discuss tweakments. I’ve noticed myself that a large proportion of new male patients find me through social media. Social media platforms, particularly Instagram and TikTok, have provided a space for men to openly discuss their experiences, showcasing their before-and-after transformations, and normalising the idea of aesthetic treatments for men. As more men share their stories and celebrate their aesthetic choices, societal perceptions are gradually shifting, promoting inclusivity and diversity in beauty standards.

The rise of influencers, celebrities, and public figures openly discussing their experiences with tweakments has had a significant impact on men's perceptions. Influential individuals sharing their positive experiences, addressing common concerns, and normalising the idea of male aesthetic treatments have greatly contributed to the increasing acceptance and curiosity among men. Celebrity endorsement and testimonies on social media platforms have effectively eroded the stigma associated with tweakments, making them more accessible and appealing to men from all walks of life.

Skincare for men: do men need the same skincare products as women? 

I’ve also noticed a significant increase in men using skincare products, and also knowing about active ingredients. This is a core adjunct to any in clinic treatment. Most men prefer a fairly simple routine that can be stuck to over the longer term, so I usually will suggest a combination of products from my own range (e.g. the Daily Skin Trio), which makes life very simple but ensures you’re getting all you need for the optimal health of your skin, with a once weekly exfoliating mask (e.g. The Red Face Peel). Occasionally I then may add in a prescription product e.g. tretinoin (a stronger prescription grade retinoid) in certain men whose skin needs a little more help, for example for those with breakouts or rosacea. Anatomically men’s skin is exactly the same as women’s, but the higher levels of testosterone in men can affect the skin in a number of ways. Higher activity of the oil (sebaceous) glands in the skin causes the skin in men to generally be more oily than women’, and the thickness of the dermis of the skin is usually higher. This being said, the needs of the skin are still the same - antioxidants, sun protection and moisture! 

What are the most popular aesthetic treatments and injectables for men?

Injectables are still (and will continue to be) the most popular treatments with men, in particular very subtle toxin treatments to lift eyelids and reduce frown lines, as well as gentle mid face, tear trough and jawline revolumisation with fillers. Dark undereye circles are often a key area of concern for men coming into clinic for the first time, so treatments like tear trough filler have become popular over recent years. Similarly, treatments aiming to boost collagen and rejuvenate skin around the eyes are gaining a lot of attention in the press, as well as mesotherapy-type treatments for skin brightening.

Another area of concern for men is sun damage and hyperpigmentation. For men born before the mid 1990s, sunscreen use (particularly in childhood) was traditionally very low, meaning that we are starting to see more and more men present with sun damage related hyperpigmentation. As such, hyperpigmentation treatments have become very popular. These focus largely on Lasers and facials treatments for hyperpigmentation and sun damage, such as Lumecca IPL™. Lumecca, one of our most popular wintertime treatments, uses a powerful light-based device over a few sessions to reduce brown marks to even out skin tone, whilst also reducing thread veins and vascular lesions.

Generally speaking, most men we have coming into clinic do not want to waste time or money on basic spa-type facials. Instead they are happy to invest in facials that utilise new technology and more comprehensive and visible results. Profhilo, an injectable biostimulator, which hydrates skin and stimulates collagen and elastin production in the dermis of the skin, has also become more popular with men as it has no risk of creating an ‘overdone’ look. In line with this, skin-tightening lasers and energy-based devices are becoming more popular for men, particularly skin tightening treatments such as Morpheus8 which helps to tighten skin that has become lax with sun damage and age.

Are there ways of making injectables look natural for men? Selecting the best injector for male injectables

Nowadays, most sensible practitioners who treat patients in a subtle way will use fairly light doses of toxin to gently treat the face and reverse the age-related changes in the dynamic muscles of the face, rather than heavy doses to paralyse the muscles completely. In the past (and in some dodgy clinics!) - toxin was injected with the aim of completely obliterating all movement in order to treat the lines. For men, in particular, this is a key concern - most men will generally not want to ever look like they’ve had anything done so choosing your practitioner is of key importance.  Everyone will be slightly different in their approach so I’d always go with a personal recommendation first and foremost, from someone you think looks normal (after treatments!), I think (and I’m sorry to say this) - you should also judge the face of your injector - if they look odd then steer clear. I’d obviously check the credentials of your doctor to make sure they are GMC registered and have plenty of experience in aesthetics. 

The best injectable techniques for men

When it comes to my approach with men, I always like to reassure them that I have an extremely conservative approach - toxin should only ever be done to reverse the change in muscle dynamics that has happened over time, and never used to completely paralyse muscles

Nowadays, most sensible practitioners who treat patients in a subtle way will use fairly light doses of toxin to gently treat the face and reverse the age-related changes in the dynamic muscles of the face, rather than heavy doses to paralyse the muscles completely. In the past (and in some dodgy clinics!) - toxin was injected with the aim of completely obliterating all movement in order to treat the lines.

 My top 5 rules for doing toxin properly are:

1. The face should always be treated as a whole (not individual parts)
2. Slight differences in muscle insertion points between individuals so the face should always be marked when moving prior to injection, the depth of injection into the skin is also an important consideration (some parts of the individual muscles are much deeper than others)
3. Dose of injection - it is important to edit the dose appropriate for the individual’s face and also higher or lower doses may be needed for certain muscles/parts of individual muscles
4. Gravity - over time, the downward pulling (depressor) muscles tend to become stronger than the lifting (elevator) muscles (eg forehead) - so as we age it’s important to avoid relaxing the elevator muscles too much and use higher doses proportionally in the depressors to give a lifting effect.
5. Relax, never paralyse and start low. The first time treating a new patient it is important to be super conservative with dosage to avoid paralysing muscles. You should always be able to move and express your face (it’s not the 90s any more in the toxin world!) - if you need more you can always add a top up after 2 weeks’ but it’s impossible to take away the effect of toxin until it wears off!

Are jawline fillers for men worthwhile?

As a key area of concern for many men, the jawline is deserving of it’s own section! Most men seeking treatments in my clinic do so for two reasons: anti-ageing or masculinisation. The former generally is slightly older men who have noticed volume loss and the appearance of jowls, as well as skin changes. The latter tends to be younger men seeking a more defined jawline and wider chin to give a more masculine appearance. Usually the approach will involve similar treatments regardless of the reason, with deep filler placement around the angle of the jawbone and chin.

Although the starting point in terms of jawline size for men is often higher than in women (with a more prominent ‘angle’ and higher, wider muscle and soft tissue bulk), the pattern of ageing in the lower face tends to be similar in both. Volume loss over time from bone, fat and muscle as slippage of some of the ligaments around the jawline results in the fat pads of the lower face slipping down and centrally, creating jowls and hollowing of cheek areas.

Volume replacement with dermal filler is a key treatment for this area. Any filler injected into the jawline will be subject to a significant forces, so I normally select a filler with a high ‘bulk’ and viscosity, starting with a small volume (to avoid overfilling), then assess and if need be, repeat the treatment two weeks to one month later. I tend only to use hyaluronic acid fillers in this area and rarely use collagen-stimulating fillers as they cannot be removed if there are any issues with these.

Conclusion 

• The rise of aesthetic treatments in men represents a broad shift in societal attitudes towards aesthetics and self-care. As more men seek to enhance their appearance, the demand for subtle, natural-looking results is increasing.
• Growing interest in treatments like toxins, dermal fillers, and skincare routines for men signifies that men are becoming more comfortable and confident in investing in themselves. This trend is not merely about vanity but a desire to look and feel their best, often spurred by social media influences and changing norms around masculinity.
• For those considering aesthetic treatments, choosing a skilled, experienced practitioner is critical to achieving natural results that enhance one's features without overdoing it. To learn more about male aesthetic treatments, check out my book “Vain Glorious: A shameless guide for men who want to look their best” or listen and subscribe to my podcast, Face Values.