Male aesthetics: A Contemporary and Technical Approach to Male Aesthetics: Anatomical Differences and Procedural Strategies

Male aesthetics is a rapidly evolving sub-discipline of aesthetic surgery and medical aesthetics with its own unique principles, aimed at preserving and optimizing masculine anatomical features.

The primary goal is to avoid creating feminine contours and instead emphasize the characteristics of sexual dimorphism (structural differences between sexes) in the face and body.

The modern approach is built on achieving sharper bone structures, defined muscle lines, and a minimally fatigued expression. The following sections examine the procedures performed on male patients, detailing their technical aspects and scientific rationale.

I. Surgical Procedures: Reshaping the Masculine Anatomy

1. Rhinoplasty (Male Nose Surgery)

The objective in male rhinoplasty is not to create a feminine, curved, or overly reduced nose, but rather a strong, natural structure proportional to the other facial features.

Technical Goals:

• Nasal Dorsum: Aim for a straight dorsum or one with a very slight hump. A concave dorsum is strictly avoided.
• Nasolabial Angle (Nose Tip–Lip Angle): For women, 100–105° is ideal, but in men, keeping it at 90–95° prevents an overly upturned appearance and maintains masculinity.
• Nasal Tip Definition: Prefer a stronger, more defined tip projection over an overly sharp or narrow one.

2. Blepharoplasty (Eyelid Surgery)

Age-related dermatochalasis (excess upper eyelid skin) and fat pad herniation (lower eyelid “bags”) obscure a dynamic and energetic expression.

Technical Goals:

• Upper Blepharoplasty: Removes excess skin while considering the supraorbital (brow bone) contour and brow position for natural results. Feminine brow lifting is avoided.
• Lower Blepharoplasty: Modern approach repositions fat pads to fill the tear trough (fat transposition) rather than removing them. Incisions are made subciliary (below lash line) or transconjunctival (inside eyelid) to conceal scars.

3. Otoplasty (Prominent Ear Surgery)

Prominent or “protruding” ears can affect facial harmony, especially in men with short hair. Otoplasty reshapes or repositions the auricular cartilage.

Technical Goals: Optimize the ear’s angle to the head and natural folds (e.g., antihelical fold) for a natural, less conspicuous look. The incision is usually hidden on the back of the ear.

4. Submental Contouring (Neck & Chin Aesthetics, Liposuction)

A sharp jawline and well-defined neck angle are key indicators of masculinity. Submental fat and sagging disrupt this contour.

• Submental Liposuction: Minimally invasive removal of localized fat under the chin to enhance the cervicomental angle.
• Platysmaplasty: If there is platysma laxity (vertical bands) or skin sagging, the muscle is tightened and excess skin excised in addition to liposuction, creating a defined, youthful neck profile.

5. Gynecomastia Correction

Gynecomastia (pathological enlargement of male breast tissue) often causes psychosocial distress. Treatment depends on tissue type.

• Glandular: Requires surgical excision of mammary tissue via periareolar incision.
• Pseudogynecomastia (Adipose-Predominant): Treated with liposuction (e.g., VASER, Laser).
• Mixed Type: Combination of liposuction + glandular excision. Goal: a flat chest contour highlighting the pectoral muscle. Further reading: Gynecomastia 101 Q&A.

6. High-Definition Liposculpture (Body Contouring)

An advanced technique that reveals muscle anatomy beyond simple fat removal.

• VASER® Technology: Ultrasonic energy selectively emulsifies fat cells, sparing vessels, nerves, connective tissue. Results: less bruising, faster recovery, tighter skin.
• Abdominal Etching: Fat planes sculpted along linea alba & lineae semilunares to create a six-pack appearance.
• Other Areas: Enhances pectoral, deltoid, serratus anterior muscle definition.

7. Hair Restoration (Hair Transplantation)

The most permanent solution for androgenetic alopecia. Involves transplanting individual grafts from a donor area.

• FUE (Follicular Unit Extraction): Extracts grafts individually using micromotors. Quick recovery, no linear scar.
• DHI (Direct Hair Implantation): Directly implants grafts with an implanter pen (Choi Pen) without channel creation.

II. Minimally Invasive Medical Aesthetic Procedures

1. Neuromodulators (Botulinum Toxin A – “Brotox”)

Men’s stronger facial muscles (e.g., procerus, corrugator) require higher dosages than women.

Strategy: Soften dynamic wrinkles without freezing expression and avoid feminine arches from over-lifting brows. Common sites: glabella, forehead, periorbital. Also used for masseter hypertrophy and hyperhidrosis.

2. Dermal Fillers

Male fillers should have higher G′ (G-prime) for better viscosity and lifting. Preferred: CaHA or dense cross-linked HA.

• Mandible (Jawline): Injections along angle and jawline for a sharp, defined contour.
• Mentum (Chin): Increases projection for a stronger profile.
• Zygomatic Arch (Cheekbone): Supports mid-face, reduces tired look, avoids rounded female cheek effect.

3. Energy-Based Devices and Skin Rejuvenation

• Laser Hair Removal: Permanent hair reduction on back, shoulders, chest.
• Ablative/Non-Ablative Lasers: (Fractional CO2, Erbium) Treat acne scars, deep wrinkles, improve skin texture.
• Radiofrequency (RF): Heats deep skin layers to stimulate collagen & elastin. Improves tightness and jawline definition.
• IPL (Intense Pulsed Light): Broad-spectrum light for pigmentation & vascular lesions. Brightens and evens skin tone.
• Ultherapy (Micro-Focused Ultrasound): Targets deep layers (including SMAS), induces collagen response, achieving non-surgical lifting.
• PRP & Mesotherapy: Growth factor–rich plasma injections improve skin quality, reduce fine lines, slow hair loss.

Individualized and Holistic Approach

A successful male aesthetic practice requires a holistic evaluation of unique anatomy, goals, and lifestyle. Planning must optimize natural proportions without exaggerating or distorting masculine traits. Consultation with an experienced plastic surgeon is essential to determine the most appropriate protocol.