ARTICLE | THEAGEING MALE | The reduction of axillary hyperhidrosis — through


treatment with botulinum toxin — is also of significant demand as men will often sweat more than women, and which will generally be more acidic and therefore more odorous. The sweating response to heat appears to be lower in women than in men, and females demonstrate a higher threshold to the onset of exercise-related sweating.


Dermal fillers Men are less interested in correcting wrinkles than erasing their tired looks11


.


the neck, as well as the hands and the abdomen. Following the trend for stubble, men want their beard outline to be redrawn by erasing hairs on the cheekbones and the neck. Of course, the older generation will focus hair removal on the nose and ears.


Men now desire increasingly , and


so dermal filler volumisers are a more appropriate treatment protocol as they will create a real frame for the face and heighten bone structure23


The most important male demand for the


clean and healthy-looking skin, with a fresh complexion. For this purpose, the younger generation are willing to accept recurring sessions of treatments such as


face relates to the periorbital circle and the tear trough. The tear trough is treated using a cannula. Cannulae are more appropriate for this area of the face, as they result in less trauma and less haematoma. It is imperative to be aware that men are more sensitive to the potential side-effects of treatment as the dermis is 10–15% thicker, and for this reason a 25 G cannula is recommended (as opposed to a 27 G). Furthermore, in the periorbital area, the water content and retention is lower in men, meaning that a relatively more hydrophilic hyaluronic acid can be used in these areas. Treatment to the face should be considered as a whole;


losing malar fat increases the appearance of nasolabial folds. Chronologically, the first treatment will treat the tear troughs with a cannula and hyaluronic acid, which is strongly stabilised and of a large calibration. Two weeks later the nasolabial folds can be filled with hyaluronic acid strongly stabilised, but with a medium calibration. Some men may have deep lines that resemble a


cracking of the dermis. This indication should also be treated in two stages. At the first session, a hyaluronic acid with a medium calibration and light stabilisation is injected into the deep dermis using a 27 G cannula. At the second session, a hyaluronic acid with a fine calibration and more highly stabilised is injected into the superficial dermis using a 30 G cannula. The chin and submental area are also important for an


attractive appearance in the male patient. As the maxillary bone resorbs, to counter this we fill the area with a strongly stabilised hyaluronic acid of a large calibration to the marionette lines, and completed with two injection points of botulinum toxin in each mentalis branch.


Skin quality Men now desire increasingly clean and healthy-looking skin, with a fresh complexion. For this purpose, the younger generation are willing to accept recurring sessions of treatments such as LED, radiofrequency or chemical peels, which are still often rejected by older patients. The younger generation are also more likely to request


cleaner-shaven skin than the more mature generation, targeting areas such as the shoulders, back, and nape of


26 ❚


LED, radiofrequency or chemical peels, which are still often rejected by older patients.


Conclusions At a time when life expectancy is constantly increasing, both genders will only benefit from a good appearance. However, women are not only more accustomed to the embellishing technique, but are also the main target for cosmetic treatments. This is perhaps the reason why, in just a few decades, women have learnt how to grow old gracefully. A woman over 50 years of age can still be very attractive, and when she reaches older age, she is often more lively and dynamic than her male counterpart. It is now men’s turn to reach this stage. The


author hopes that cosmetic and anti-ageing medicine will help them to enhance their vitality, following the example of their spouses. While the beauty care applied to and by women cannot be transferred to men, it is the role of the physician to adapt this, to match male specifications and supply men with treatments that meet their expectations.


 Declaration of interest None  Figures 1 and 2 © Catherine De Goursac


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November/December 2012 | prime-journal.com


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