Rejuvenation of the male face with botulinum toxin injections: practical recommendations

Botulinum toxin injections – The most sought after non-surgical aesthetic procedure among men, approved for smoothing wrinkles between the eyebrows, forehead and crow's feet, but in practice it is also used to correct other areas of the face. When working with this category of patients, the practitioner should be aware of the gendered features of male facial rejuvenation, which include the goals of the procedure, the anatomy of the target sites, and the >dosage and administration of BoNTA. These questions are discussed by Dr. Ahmed El Houssieny in the article estet-portal.com.

• Male perception of facial rejuvenation and treatment goals
• Anatomical features and assessment of the condition of the male face
• Botulinum toxin dosage for male facial rejuvenation
• Points and schemes for the administration of Botulinum toxin for men

Male perception of facial rejuvenation and the goals of the procedure

During the initial consultation, the physician should take the patient's history and clearly define their expectations and goals.

It is important to understand that men and women agree to cosmetic procedures for different reasons.

The most common goals and expectations for aesthetic procedures in men:

• get rid of signs of fatigue on the face;
• get a light facial rejuvenation effect;
• increase your competitiveness and become more successful in the professional field;
• preserve or emphasize one's masculinity;
• hide traces of intervention by an esthetician.

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Thus, men need to hide the signs of fatigue and "old age", while maintaining the signs of age and experience on the face.

Anatomical features and assessment of the condition of the male face

When assessing the condition of the face before performing botulinum toxin injections in men, it is important to take into account the peculiarities of the structure of their skeleton, muscles and skin.

Features of the bone structures of the male face:

• larger skull size;
• more prominent brow ridges;
• big protruding chin;
• more pronounced curve of the mandible.

 

 

In the upper third of the face in men:

• more even and located lower on the superciliary arch than in women;
• glabella projection is more pronounced;
• wider and higher forehead that curves in the direction of the hairline;
• Age-related hair loss leads to an increase in forehead height in men.

The thickness of the skin in men is greater than that of women, as is the density of the arrangement of blood vessels on the face.

The skeletal muscles of men are more massive than women's. For example, the muscles of the glabellar complex have a large mass and strength in men. With increased muscle activity, the depth of mimic wrinkles increases.

Features of wrinkles on a male face:

1. The size of the proud muscles in men determines the V-shape of the wrinkles between the eyebrows.
2. Male crow's feet are often lower and fan-shaped.
3. Wrinkle depth varies according to muscle activity.

Before botulinum toxin injections, it is necessary to assess the male face at rest, as well as during mimic activity, palpating areas of stronger contraction, dynamic mobility and deep wrinkles. Dosage of botulinum toxin preparations for male facial rejuvenation

Available studies demonstrate the need to administer more

o

higher doses of abo- and onabotuotoxin to men to correct the glabellar complex than women.

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Correction of angles and contours of the lower jaw with botulinum toxin type A If

20 units

of onabotulinum toxin type A is enough for a good effect in the area between the eyebrows, then for men, according to various studies, 40 & ndash;80 units provide a pronounced and long-term effect. BoNTA. Of course, the dose of the drug should be selected depending on the specific case and the individual characteristics of the patient's face. At the same time, increasing the dose of botulinum toxin for male facial rejuvenation does not correlate with an increase in the incidence of adverse events after the procedure.

It is important to remember that the units of abobotulinum toxin type A, onabotulinumtoxin type A, and incobotulinumtoxin type A are not equivalent.

The literature has not determined the optimal dose of BoNTA for smoothing wrinkles at the corners of the eyes and forehead in men. However, in such cases, you can be guided by the general practice of –

10–25% increase

in the dose used to correct female face. Points and schemes for administering botulinum toxin to men

To ensure optimal results in male facial rejuvenation with botulinum toxin injections, it is important to choose the right injection sites and take into account the interaction of the muscles involved.

 

Fig. 1

The

eyebrow area

requires special attention and a balanced approach to correction. As stated above, in men they have a more even shape. The creation of a curve as a result of correction with botulinum toxin will lead to feminization of the face. According to the data available in the literature, when injecting the toxin into the frontalis muscle, the injection points should be placed in a row, and also work out the lateral part of the frontalis muscle to avoid its contraction, which leads to the formation of an eyebrow bend . During

glabellar correction

the practitioner should always be aware of the interaction:

frontalis muscle;

• muscles of the proud;
• eyebrow wrinkler;
• circular muscle of the eye.
It is therefore advisable to inject

2 units of she-/incobotulinum toxin or 5 units of abobotulinumtoxin into the lateral part of the frontalis muscle

above the eyebrow. The injection scheme for the correction of the mideyebrow in men includes 7 injection points, and not 5, as in women (Fig. 1).

Read also:

Rejuvenation of the area around the eyes in men: features of correction with fillers and botulinum toxin More than one insertion point along the bottom of the vertical fibers of the orbicularis oculi muscle may also be needed to correct

crow's feet in men

, as most men have downward fan-shaped lateral canthal lines. Thus, the practitioner must take into account not only the anatomical differences between the male and female face, but also the final goals of the procedure that the patient sets for the doctor. An individual approach to the choice of points and the number of administered drugs remains relevant, regardless of the gender of the patient.

Adapted from Aesthetics.

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