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Deane EC, Wong A, Bloom JD. Fat Grafting the Male Face. Facial Plast Surg Clin North Am 2024; 32:391-398. [PMID: 38936996 DOI: 10.1016/j.fsc.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
There are many developmental sexual dimorphisms of the human face, and thereby differences in aging based on sex. Sensitivity regarding the nature of the changes that are unique to the male face as well as understanding men's unique aesthetic goals will allow the skilled practitioner to tailor rejuvenating treatments accordingly. Fat grafting of the male face has not been extensively described but is an excellent tool for facial rejuvenation either as an adjunct or a stand-alone procedure. Each treatment area demands different techniques and special attention to avoid unintentional feminization.
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Affiliation(s)
- Emily C Deane
- Facial Plastic & Reconstructive Surgery, Department of Otolaryngology Head & Neck Surgery, University of Pennsylvania, 3737 Market Street, Suite 302, Philadelphia, PA 19104, USA
| | - Anni Wong
- Facial Plastic & Reconstructive Surgery, Department of Otolaryngology Head & Neck Surgery, University of Pennsylvania, 3737 Market Street, Suite 302, Philadelphia, PA 19104, USA
| | - Jason D Bloom
- Facial Plastic & Reconstructive Surgery, Department of Otolaryngology Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA; Bloom Facial Plastic Surgery, Two Town Place, Suite 110, Bryn Mawr, PA 19010, USA.
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2
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Somenek M. Minimally Invasive Male Facial Rejuvenation: Energy-Based Devices. Facial Plast Surg Clin North Am 2024; 32:437-445. [PMID: 38937001 DOI: 10.1016/j.fsc.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
The development of minimally invasive, non-surgical, and office-based procedures that have minimal downtime has stimulated an interest among men who may seek cosmetic treatments to increase competitiveness and appear youthful in the workplace. There has also been greater media attention on the male appearance and grooming along with increasing acceptance of cosmetic procedures within society. Achieving a successful cosmetic treatment in a male patient requires the physician to recognize the gender differences that exist. These include anatomy, skin aging, and skin biology, as well as behavioral patterns that exist in this population.
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Affiliation(s)
- Michael Somenek
- Somenek+Pittman MD, Advanced Plastic Surgery, 2440 M Street NW, Suite 507, Washington, DC 20037, USA.
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Farashi F, Ghoncheh M, Ghasemian Moghaddam MR, Soroosh Z. Evaluation of people's satisfaction with botulinum toxin injection for facial rejuvenation based on age. J Cosmet Dermatol 2024; 23:2380-2385. [PMID: 38500014 DOI: 10.1111/jocd.16289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/08/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Botulinum toxin type A injections are widely used for facial rejuvenation; however, research on people's satisfaction based on age is limited. This study assessed patient satisfaction with botulinum toxin injections for forehead, glabella, and periorbital wrinkles in Birjand, Iran. PATIENTS AND METHODS The current study examined 150 people aged 18 to 70 who requested botulinum toxin type A injection in the forehead, glabellar, and periorbital area in 2022, who visited the plastic surgery clinic and the authors' offices in Birjand City. To check patients' satisfaction, Facial Lines Treatment Satisfaction (FTS) Questionnaire was used. One month after botulinum toxin type A injection, this questionnaire was completed by the clients. Also, the brand type of botulinum toxin, age, gender of the clients, frequency of visits, and complications were collected in the relevant checklist. RESULTS The average age of participants was 38.8 ± 8.29 years with 73.3% being female. Masport botulinum toxin (MasoonDarou Pharmaceutical Company, I.R. Iran) was the most frequently used botulinum toxin brand at 66.7%. The average satisfaction score with the result of botulinum toxin injection in the forehead/glabella and periorbital area, in the age group under 30 years and 30-40 years, was significantly higher than in the age group over 50 years. The same indicators in the age group under 30 years old were significantly higher than in the 30-40 age group (p < 0.05). Furthermore, brand selection and the number of visits (first-time vs. second-time clients) demonstrated varied outcomes in satisfaction. There was a total of 62.7% side effects postinjection, with varying degrees of severity.
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Affiliation(s)
| | - Mahdi Ghoncheh
- Department of Surgery, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Zahra Soroosh
- Department of Family and Community Medicine, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
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Akhavan AA, Pang JH, Morrison SD, Satterwhite T. Gender Affirming Facial Surgery-Anatomy and Procedures for Facial Masculinization. Oral Maxillofac Surg Clin North Am 2024; 36:221-236. [PMID: 38458858 DOI: 10.1016/j.coms.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
For some patients, feminine facial features may cause significant gender dysphoria. Multiple nonsurgical and surgical techniques exist to masculinize facial features. Nonsurgical techniques include testosterone supplementation and dermal fillers. Surgical techniques include soft tissue manipulation, synthetic implants, regenerative scaffolding, or bony reconstruction. Many techniques are derived from experience with cisgender patients, but are adapted with special considerations to differing anatomy between cisgender and transgender men and women. Currently, facial masculinization is less commonly sought than feminization, but demand is likely to increase as techniques are refined and made available.
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Affiliation(s)
- Arya Andre Akhavan
- Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Suite E1620, Newark, NJ 07103, USA; Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA
| | - John Henry Pang
- Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA
| | - Shane D Morrison
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356165, Seattle, WA 98195, USA
| | - Thomas Satterwhite
- Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA; Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center.
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Cattelan L, Dayan S, Aguilera SB, Viscomi B, Fabi SG. A Review of Aesthetic Considerations for Treating the Transgender Patient. Dermatol Surg 2024:00042728-990000000-00673. [PMID: 38349851 DOI: 10.1097/dss.0000000000004112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
BACKGROUND As gender diversity becomes increasingly embraced by society, and despite growing recognition of the unique needs of transgender patients, the literature remains devoid of guidelines for gender affirming facial feminization or masculinization techniques. OBJECTIVE The authors seek to identify and discuss target feminine and masculine facial features, as well as an armamentarium of surgical and nonsurgical strategies to effectively address and achieve them in the transgender population. METHODS A search of the National Library of Medicine database (PubMed) was undertaken to identify the existing literature on gender-affirming facial feminization and masculinization techniques. RESULTS The importance of assessing proportional relationships between the bitemporal, bizygomatic, and bigonial distances is discussed; ideal masculine faces possess a rectangular face shape, with ratios for these 3 areas tending toward 1:1:1. Conversely, the ideal female face is heart shaped with projection at the zygoma and a tapered jawline. Strategic positioning of the cheek apex serves as an anchor in sculpting a distinctly masculine or feminine face. Other considerations include the enhancement of skin quality and implications of hormonal therapy. CONCLUSION The aesthetic considerations provided in this study can serve as a valuable guidance for aesthetic physicians seeking to deliver optimal care for their transitioning patients.
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Affiliation(s)
- Leila Cattelan
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Steven Dayan
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, University of Illinois at Chicago, Chicago, Illinois
| | - Shino Bay Aguilera
- Shino Bay Cosmetic Dermatology & Laser Institute, Fort Lauderdale, Florida
| | - Bianca Viscomi
- Bianca Viscomi Dermatologia Private Practice, São Paulo, Brazil
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Ghorbani A, Piroozi B, Safari H, Shokri A, Aqaei A, Yousefi F, Nikouei M, Rafieemovahhed M. Prevalence of elective cosmetic surgery and its relationship with socioeconomic and mental health: A cross-sectional study in west of Iran. Health Sci Rep 2022; 5:e872. [PMID: 36268461 PMCID: PMC9577119 DOI: 10.1002/hsr2.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Aims The aim of this study was to investigate the prevalence and desire towards performing elective cosmetic surgery and its relationship with socioeconomic, mental, and spiritual health in Sanandaj, the capital of Kurdistan province in the west of Iran. Methods This cross‐sectional descriptive‐analytical study was performed on 492 subjects in Sanandaj using multistage sampling method. Data collection tools included two checklists and two questionnaires. Data analysis was performed using the Chi‐square test and multiple logistics regression model by the help of SPSS software version 20. Results The mean (standard deviation) age of participants was 32.58 (9.67) years. The prevalence of cosmetic surgery and the desire to perform it were 12.8% (n = 63) and 19.1% (n = 94), respectively. The most common type of cosmetic surgery was rhinoplasty with 5.5% (n = 27). The prevalence of symptoms of mental disorders among people with cosmetic surgery and people willing to perform cosmetic surgery was significantly higher than all subjects (p < 0.001). Female gender (odds ratio [OR] = 1.98; 95% confidence interval [CI]: 1.06–3.68) and having mild (OR = 3.01 95% CI: 1.06–3.68) and moderate to severe symptoms of mental disorder (OR = 7.59; 95% CI: 3.90–14.75) were among the influential variables on performing cosmetic surgery. Conclusion Both the prevalence and desire towards performing cosmetic surgery are high in Sanandaj and this needs the attention of health policy makers. Designing targeted interventions with an emphasis on the findings of this study is proposed to reduce these practices.
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Affiliation(s)
- Ahoora Ghorbani
- Research Student CommitteeKurdistan University of Medical SciencesSanandajIran
| | - Bakhtiar Piroozi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Hossein Safari
- Health Promotion Research CenterIran University of Medical SciencesTehranIran,School of Nursing and MidwiferyQazvin University of Medical SciencesQazvinIran
| | - Azad Shokri
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Abbas Aqaei
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Fayegh Yousefi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Maziar Nikouei
- Research Student CommitteeKurdistan University of Medical SciencesSanandajIran
| | - Mahdi Rafieemovahhed
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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Mastroluca E, Patalano M, Bertossi D. Minimally invasive aesthetic treatment of male patients: The importance of consultation and the lower third of the face. J Cosmet Dermatol 2021; 20:2086-2092. [PMID: 33993643 PMCID: PMC8361772 DOI: 10.1111/jocd.14231] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/14/2021] [Accepted: 05/07/2021] [Indexed: 11/28/2022]
Abstract
Background Men worry disproportionately about potential negative consequences of facial aesthetic treatment with injectable therapies, such as side effects or appearing more feminine. Features of the lower third of the face (eg, prominent chin and jaw) are particularly important in perceptions of masculinity. A strategy has been developed for male patients based on an initial consultation emphasizing the safety and masculinizing potential of injectables, followed by treatment with a high G’ hyaluronic acid filler targeting the lower third. Aims To assess this strategy in routine practice. Methods This was a retrospective analysis of male patients with poor definition of the lower third of the face wishing to undergo non‐surgical correction. Initial consultation focused on detailed patient education and facial masculinization with injectables. Individuals were then treated in the lower third using VYC‐25 based on the standardized MD Codes approach. Follow‐up lasted ≤12 months. Results Forty patients were included (mean age: 40.9 ± 9.6 years). The mean volume of VYC‐25 injected into the lower third was 7.8 ± 1.2 ml. Patient satisfaction was high, as assessed using the FACE‐Q “Satisfaction with outcome” questionnaire (mean Rasch‐transformed score: 88.1 ± 10.3). Complications included the following: soft tissue edema, n = 12 (30.0%); hematoma, n = 6 (15.0%); and telangiectasia, n = 2 (5.0%). All were early, transient, and minor; there were no major or delayed events. Conclusions This approach to male subjects was practical and safe despite the large volumes of filler used. Focusing on the lower third may help to reassure patients and deliver results that respect masculine identity.
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Affiliation(s)
| | | | - Dario Bertossi
- Department of Surgery, Dentistry, Pediatrics and Gynaecology, University of Verona, Policlinico G.B. Rossi, Piazzale LA Scuro 10, Verona, Italy, 37134, Italy
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De Boulle K, Furuyama N, Heydenrych I, Keaney T, Rivkin A, Wong V, Silberberg M. Considerations for the Use of Minimally Invasive Aesthetic Procedures for Facial Remodeling in Transgender Individuals. Clin Cosmet Investig Dermatol 2021; 14:513-525. [PMID: 34012284 PMCID: PMC8128506 DOI: 10.2147/ccid.s304032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022]
Abstract
There is increasing demand among transgender individuals for minimally invasive aesthetic procedures, such as injectable facial fillers and neurotoxins, for facial remodeling and transformation. These procedures may increase transgender individuals’ satisfaction with their appearance and allow them to more effectively harmonize their physical appearance with their perception of self. There is currently a lack of information in the medical literature regarding guidelines for the use of these products in transgender patients. In this report, the authors provide experience-based treatment considerations and recommendations for use of minimally invasive facial aesthetic procedures in transgender patients, including case studies illustrating the use of these procedures for both male-to-female and female-to-male transitioning patients. This report highlights the success of minimally invasive methods for assisting transgender patients in achieving their facial remodeling goals. Clinicians play an integral role in the transitioning process for transgender patients, and facial transformation is a key element of this process. When conducted with sensitivity and attention to individual patient goals at varying stages of transition, facial procedures can be of great benefit in enhancing patients’ self-perception and overall quality of life.
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Affiliation(s)
| | | | - Izolda Heydenrych
- Cape Town Cosmetic Dermatology Centre, Cape Town, South Africa.,Division of Dermatology, Faculty of Health Sciences, University of Stellenbosch, Stellenbosch, South Africa
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Kim D, Tu YM, Chapas A. What Women Want: Women's Perspectives on Male Cosmetic Procedures. Dermatol Surg 2021; 47:250-255. [PMID: 33565778 DOI: 10.1097/dss.0000000000002784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The rate of growth for male cosmetic treatments has slowed in the past 5 years. There is limited data on why men may not seek cosmetic treatments. OBJECTIVE To evaluate women's perspectives on male cosmetic treatments. METHODS Heterosexual female patients (single (n = 64); in a relationship/married (IR/M) (n = 136)) completed an online survey. RESULTS 87.5% of single and 36.03% of IR/M women reported that men are bothered by signs of aging (p < .0001). However, both single and IR/M women reported that men are interested in (single: 77.78%, IR/M: 65.44%) and will benefit (single: 93.55%, IR/M: 67.31%) from cosmetic procedures. Both groups of women (single: 93.75%, IR/M: 83.82%, p < .0530) indicated, however, that men are reluctant to seek cosmetic treatments. Societal stigma/perception of masculinity was the number one cited reason (single: 87.1.75%, IR/M: 73.02%, p < .0264). However, 87.5% of single and 94.86% of IR/M women (p = .0659) reported that male cosmetic treatments will not affect their perceptions of masculinity. Furthermore, 95% of women (single: 95.31%, IR/M: 95.59%, p = .9292) reported that they will support their partners from pursuing cosmetic treatments. CONCLUSION Women strongly believe that men can benefit from cosmetic treatments, do not believe cosmetic treatments affect masculinity, and are overwhelmingly supportive of male cosmetic treatments.
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Affiliation(s)
- David Kim
- All authors are affiliated with the Union Square Laser Dermatology, New York City, New York
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10
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Nestor MS, Arnold D, Fischer D. The mechanisms of action and use of botulinum neurotoxin type A in aesthetics: Key Clinical Postulates II. J Cosmet Dermatol 2020; 19:2785-2804. [PMID: 32866999 PMCID: PMC7693297 DOI: 10.1111/jocd.13702] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The literature on botulinum neurotoxin type A (BoNT-A) is extensive, often contradictory, and confounded by a competitive market of products and research attempting to distinguish brand individuality. METHODS A comprehensive review of literature on the principles of BoNT-A in aesthetics as well as clinical examples. RESULTS In 2017, the Eight Key Clinical Postulates were formulated as a guide for the aesthetic practitioner in understanding BoNT-A pharmacodynamics and to compare different toxins. These are now updated to include (a) All type A toxins act identically; (b) The mathematical relationship between toxin and receptor is the basis of efficacy, and clinical efficacy is influenced by molecular potency and patient attributes including muscle mass, gender, age, and ethnicity; (c) Efficacy, onset, and duration are functions of "molecular potency" defined as the number of active 150 kDa molecules available for binding; (d) "Molecular potency" is difficult to objectively quantify for commercially available toxins; (e) Up to a point, increased molecular potency decreases time to onset and increases duration of effect, and the "Molecular Potency Quotient" is a construct for comparing molecular potency commercial cost; (f) The area of effect of a toxin injection is dependent upon molecular potency, diffusion (passive), and spread (active); (g) Differing reconstitution volumes; and (h) Increased number of injection sites can affect spread, onset, and duration of effect. CONCLUSIONS The principles of BoNT-A use in aesthetics are complex yet understandable as outlined in the framework of the updated Eight Key Clinical Postulates and serves as a useful tool for providing the most effective treatment and interpreting research on present and future toxin formulations.
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Affiliation(s)
- Mark S. Nestor
- Center for Clinical and Cosmetic ResearchAventuraFloridaUSA
- Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of MedicineMiamiFloridaUSA
- Department of SurgeryDivision of Plastic SurgeryUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - David Arnold
- Center for Clinical and Cosmetic ResearchAventuraFloridaUSA
| | - Daniel Fischer
- Center for Clinical and Cosmetic ResearchAventuraFloridaUSA
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12
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Haiun M, Cardon-Fréville L, Picard F, Meningaud JP, Hersant B. [Peculiarities of botulinum toxin injections for the aesthetic treatment of men's face. A review of the literature]. ANN CHIR PLAST ESTH 2019; 64:259-265. [PMID: 31005350 DOI: 10.1016/j.anplas.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Botulinum toxin injections in aesthetic medicine are the most widely used products, ahead of hyaluronic acid, and aesthetic medicine is constantly increasing, including in the male population. The objective of this development was to show the specificities described in the literature concerning botulinum toxin injections in men. MATERIAL AND METHOD A systematic literature search was carried out using the Pubmed search engine. Data were then collected to determine the specificities of botulinum toxin injections in men according to the morphology of the male face and the wishes of these patients. RESULTS The studies conducted show that it is necessary to inject higher doses in men than in women to obtain a satisfactory result, due to a higher muscle mass. This adjustment gives the number of points to be performed per injection site, as well as the number of points to be performed, compared to the female population. CONCLUSION Botulinum toxin injections for aesthetic purposes in men are different from those in women. Taking these particularities into account is essential to patient satisfaction.
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Affiliation(s)
- M Haiun
- Service de chirurgie plastique, reconstructrice et esthétique, et chirurgie maxillofaciale, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
| | - L Cardon-Fréville
- Service de chirurgie plastique, reconstructrice et esthétique, 2, rue Louis-Maurel, 13006 Marseille, France
| | - F Picard
- Service de chirurgie plastique, reconstructrice et esthétique, et chirurgie maxillofaciale, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - J-P Meningaud
- Service de chirurgie plastique, reconstructrice et esthétique, et chirurgie maxillofaciale, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - B Hersant
- Service de chirurgie plastique, reconstructrice et esthétique, et chirurgie maxillofaciale, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
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13
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Ascha M, Swanson MA, Massie JP, Evans MW, Chambers C, Ginsberg BA, Gatherwright J, Satterwhite T, Morrison SD, Gougoutas AJ. Nonsurgical Management of Facial Masculinization and Feminization. Aesthet Surg J 2019; 39:NP123-NP137. [PMID: 30383180 DOI: 10.1093/asj/sjy253] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Transgender patients may seek nonsurgical methods for facial masculinization and feminization as an adjunct or alternative to undergoing surgical procedures. OBJECTIVES The authors reviewed the existing literature regarding this topic and provided an overview of nonsurgical techniques for facial masculinization and feminization. METHODS A comprehensive literature search of the PubMed and MedLine databases was conducted for studies published through December 2017 for techniques and outcomes of nonsurgical facial masculinization and feminization. Keywords were used in performing the search. Data on techniques, outcomes, complications, and patient satisfaction were collected. RESULTS Four articles fit our inclusion criteria. Given the lack of published literature describing facial injectables in transgender patients, data from the literature describing techniques in cisgender patients were utilized to supplement our review. CONCLUSIONS Facial feminization can be achieved through injectables such as neurotoxin and fillers for lateral brow elevation, lip augmentation, malar augmentation, and improvement of rhytids. Facial masculinization can be achieved with injectables used for genioplasty, jawline augmentation, and supraorbital ridge augmentation. One must develop best practices for these techniques in the transgender patient population and increase awareness regarding nonsurgical options. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Mona Ascha
- Division of Plastic Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Marco A Swanson
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Jonathan P Massie
- Division of Plastic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Morgan W Evans
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA
| | - Christopher Chambers
- Division of Oculoplastic Surgery, Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA
| | - Brian A Ginsberg
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Shane D Morrison
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA
| | - Alexander J Gougoutas
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA
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14
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Alam M, Tung R. Injection technique in neurotoxins and fillers: Planning and basic technique. J Am Acad Dermatol 2018; 79:407-419. [DOI: 10.1016/j.jaad.2018.01.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Genital rejuvenation is applicable not only to women (vaginal rejuvenation) but also to men (scrotal rejuvenation). There is an increased awareness, reflected by the number of published medical papers, of vaginal rejuvenation; however, rejuvenation of the scrotum has not received similar attention in the medical literature. Scrotal rejuvenation includes treatment of hair-associated scrotal changes (alopecia and hypertrichosis), morphology-associated scrotal changes (wrinkling and laxity), and vascular-associated scrotal changes (angiokeratomas). Rejuvenation of the scrotum potentially may utilize medical therapy, such as topical minoxidil and oral finasteride, for scrotal alopecia and conservative modalities, such as depilatories and electrolysis, for scrotal hypertrichosis. Lasers and energy-based devices may be efficacious for scrotal hypertrichosis and scrotal angiokeratomas. Surgical intervention is the mainstay of therapy for scrotal laxity; however, absorbable suspension sutures are postulated as a potential intervention to provide an adequate scrotal lift. Hair transplantation for scrotal alopecia and injection of botulinum toxin into the dartos muscle for scrotal wrinkling are hypothesized as possible treatments for these conditions. The interest in scrotal rejuvenation is likely to increase as men and their physicians become aware of both the conditions of the scrotum that may warrant rejuvenation and the potential treatments of the scrotum for these individuals.
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Affiliation(s)
- Philip R Cohen
- Department of Dermatology, University of California, San Diego
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16
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Abstract
Men seek cosmetic procedures for vastly different reasons than women. Men often seek discrete cosmetic services with little downtime. Male skin structure generally differs from female skin structure. Dermatologists should consider subtle differences in the psyche of the male cosmetic patient.
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17
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Commentary on Signs of Facial Aging in Men in a Diverse, Multinational Study: Timing and Preventive Behaviors. Dermatol Surg 2017; 43 Suppl 2:S221-S224. [DOI: 10.1097/dss.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Chemical peels are a mainstay of aesthetic medicine and an increasingly popular cosmetic procedure performed in men. OBJECTIVE To review the indications for chemical peels with an emphasis on performing this procedure in male patients. MATERIALS AND METHODS Review of the English PubMed/MEDLINE literature and specialty texts in cosmetic dermatology, oculoplastic, and facial aesthetic surgery regarding sex-specific use of chemical peels in men. RESULTS Conditions treated successfully with chemical peels in men include acne vulgaris, acne scarring, rosacea, keratosis pilaris, melasma, actinic keratosis, photodamage, resurfacing of surgical reconstruction scars, and periorbital rejuvenation. Chemical peels are commonly combined with other nonsurgical cosmetic procedures to optimize results. Male patients may require a greater number of treatments or higher concentration of peeling agent due to increased sebaceous quality of skin and hair follicle density. CONCLUSION Chemical peels are a cost-effective and reliable treatment for a variety of aesthetic and medical skin conditions. Given the increasing demand for noninvasive cosmetic procedures among men, dermatologists should have an understanding of chemical peel applications and techniques to address the concerns of male patients.
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