Article by Dr. Benjamin COZANET, published in MERZ ESTETIC magazine N7 - Special Edition 2024-2025. PDF
Patient expectations, whether in terms of skin type, bone structure, enhancement of virility, and dynamic expression, converge toward progressive treatment, which requires a very specific anatomical and psychological approach.
Masculinity Requirements
In men, it is important not to modify volumes except after significant weight loss or dieting, due to a health concern, or in the case of an advanced patient undergoing their first treatment late in life. Men seek improved skin quality without any visible medical intervention. Since men's skin is thicker and therefore more subject to gravity than thin skin, it has a greater need for collagen and elastin to firm it.
Deep and superficial firming
For this indication, I offer my patients a combined protocol. To begin, an Ultherapy session will lay the foundations of the treatment. Micro-focused ultrasound is delivered at three different depths, allowing us to work on the subcutaneous muscle foundations, with an initial pass penetrating to 4.5 mm. The Deepsee® control screen allows real-time visualization of the treatment areas, including the SMAS, which helps me perform a precise treatment. I emphasize the mandibular angles, the square of the chin, and the submental area, which define the virility and dynamics of the male face. The second pass at 3 mm in the mid- and deep dermis lays the foundation for fibroblast stimulation, enabling the synthesis of collagen and elastin. Finally, the final pass at 1.5 mm works on the surface and reinforces skin tightening and firming, as well as a more even and luminous complexion. As with any ultrasound treatment, the results are achieved gradually, and the results are visible between 4 and 6 months. Only one session is necessary, which is very popular with men, as is the absence of volume alteration and the gradual onset of effects, meeting their demands for discretion.
Skin lifting and virility enhancement
A second session is required at 3 months to reinforce and maintain the results. The injections are administered with a cannula, with one entry point at the cheekbone and one at the angle of the jaw. The goal is always to respect and emphasize the angularity specific to the masculine face. These fan-shaped, retrotracing injections ensure optimal diffusion of the product and create tightening vectors that will subtly provide a lifting effect.
For indications involving re-masculinization of the lower face, undiluted Radiesse® can be injected with a cannula in a linear retrotracing pattern at the mandibular angle and jawline, as well as to advance and resculpt the chin by placing boluses of the product with the needle.
This action will be reinforced by an injection approximately one month later of Radiesse®, which, in my opinion, is the best tissue inducer not only for its collagen and elastin biostimulation, but also because it has proven its effectiveness—supported by published clinical studies—on angiogenesis, which is essential for vascularization and skin trophicity. For this indication, I dilute it 1 to 1 or 1 to 2 with saline, depending on skin thickness. For men with very thick or damaged skin, I offer...
THICKER MALE SKIN, MORE SUBJECT TO GRAVITY, HAS A GREATER NEED FOR COLLAGEN AND ELASTIN FOR FIRMING.
More diverse patient profiles
I see an increasingly younger patient population, sensitive to the early signs of sagging skin. They seek improvement in their skin tone and the dynamic appearance of their face, and they are aware of the preventative effect of these treatments, which preserve youthfulness. These men, often from highly competitive backgrounds such as banking, startups, or executives in industry or communications, particularly appreciate the possibility of a simple treatment, without side effects, in 2 or 3 sessions, with lasting and cumulative effects in the medium and long term. These treatments, with their gradual, non-marking results, are highly valued for their gradual effect, where the doctor's intervention is undetectable by those around them. This perfectly meets their requirements for effectiveness, discretion, and durability.