Men get facial fillers for different reasons than women. Here's my experience

When I walked into Christy Adams's office in New York City’s Soho 45 minutes ago, my jaw wasn't quite so square as it is now. My chin wasn't jutting, nor my cheekbones so chiseled. The crease above my chin, the tear troughs below my eyes, and my nasolabial folds — the lines running from the corners of my mouth to my nostrils — were also noticeably deeper.

Now, in the mirror, I appear at once more masculine and, if not younger, certainly less like I'd been ridden hard and put away wet. And all it took was around five syringes, or 5 CCs, of injectable facial fillers with a combined retail value of around $4,350 (full transparency: It was comped for me, for the purpose of experiencing and writing about fillers). Adams also administered the Botox — 60 units, worth $840 — that brought me into her office, but, unlike the fillers, any results would only begin to show up several days later.

While I knew that my 43-year-old face would surely benefit from some tweaks, I hadn't anticipated how much of these substances would be used and exactly where they would be employed. All I did know is that my number one criterion for choosing a date spot was no longer the quality of food, nor the ingenuity of the cocktails, but warm, low, forgiving light. So something had to be done.

"That's one of the biggest differences between men and women when it comes to filler," says Adams. "Women want specific things. They show me pictures and say 'I want these lips' or 'I want her cheekbones' and don't particularly want to hear what I have to say. Men just say, 'I want to look better.'” In general, Adams tells me, men are quicker to trust that she knows what she’s doing and, not coincidentally, are even more satisfied with the results.

While cosmetic procedures are most often associated with women, the first person Adams ever injected with filler was male. "I went to a workshop and brought a girlfriend along as my model as we were all asked to do," Adams says. "Neither of us had any idea that we'd all be asked to swap models to do the injecting. I got a guy. So injecting men is nothing new for me, and now I'd say around 30% of my clientele are men."

The stigma of a guy getting fillers is steadily dissipating since many of us are thankfully reconsidering gender norms and stereotypes, it's not yet something most men are posting about on social media or openly discussing with their buddies. "Look, often guys don't tell anyone about it because they don't need to tell anyone about it," says the agelessly beautiful but decidedly natural-looking Adams, who has seven years of experience as an injector and many more as a registered nurse.

Unlike many other cosmetic interventions, there is typically no downtime with fillers — any redness or bruising tends to subside within a few hours. Another thing that is bringing men to fillers, she says, is that many of the injectables, such as the growing range of Juvederm and Restalyne products made from hyaluronic acid, interestingly, have an antidote. Less than psyched with the results of your filler session? An enzyme called hyaluronidase can be used to dissolve it. This trick can't be performed on work done with fillers like Radiesse and Sculptra, however, as they are made from different stuff — calcium hydroxyapatite and poly-L-lactic acid, respectively. If you’re not pleased with the result of these, the only antidote is time.

While there are differences in weight, viscosity, and fixity of these products, they all broadly do the same thing — plump up that which is not as plump as once was. Fillers, quite simply, fill.

Along with the lack of downtime and the undoability of fillers, when done properly, they aren’t generally noticeable. This is helpful if a guy feels some type of way about admitting he got “work” done. "People may remark that you look handsome, well-rested, or have lost weight — not that you look ‘done.’ My job is to make sure you don't look like you just had fillers,” Adams says.

So are all men secretly bum-rushing the filler bandwagon? Well, sort of, though not lately. The use of Botox and Dysport — neurotoxins, which reduce muscle movement and soften wrinkles — has steadily risen among men year on year. However, despite all the things men apparently like about fillers, 2018 saw a drop of 13.5% in men using them from the previous year — this according to statistics from the Cosmetic Aesthetic Surgery Data Bank. Exactly why isn't clear, though the sudden drop off seems to coincide with reports of all-manner of dodgy workmanship in the media.

First, there was the chatter about something called filler-fatigue — a purported situation in which repeated and overzealous filler use bags out the skin, requiring ever more filler, resulting in an ever-expanding face. Then there was the latest spate of people going blind from filler use and graphic Instagram posts of filler gone wrong, including one that shows what can happen when a vascular occlusion caused by dermal fillers causes necrosis. Of course, all this should dampen enthusiasm for fillers regardless of gender, so perhaps it was pictures of famous reportedly filled men — Tom Cruise, Sylvester Stallone, and Simon Cowell — each sporting a head resembling ten pounds of sausage in a five-pound bag that started to turn guys off.

"Of course, there are risks that go with fillers, like mild bruising and swelling," says New York City-based dermatologist Michele Green, adding that both major and minor risks associated with fillers are directly related to the level of training a practitioner has. "I'm sure it still happens at clinics and spas, where they have a five-hour course and then the companies that manufacture the product. But I don't see as many patients complaining about the work of other providers as I used to."

Green adds that the risks associated with injecting filler into the nose, in particular, are so grave that — like SkinSplendid's Adams — she doesn't inject filler there as a rule.

And as for filler fatigue, Green says that she has not seen filler fatigue in her practice with men or women. "If there is skin laxity that cannot be corrected with skin tightening lasers such as the Thermage FLX or injectables such as Sculptra or Radiesse, which produce new collagen in a pan facial way, then those patients with extra skin will need a surgical treatment." It's worth pointing out that a lot of support for — and likely the concept of — filler fatigue comes from the plastic surgeons who are losing market share to injectors. As of now, there's not much research to shed light on whether filler fatigue is real or not.

What is not in doubt is my handsomeness — at least relative to how I looked less than an hour ago. With my jaw looking positively Pattinson-esque, I'm thrilled to have given Adams the freedom to realize her vision for my mug. At the same time, I'm worried that I'll be forking over this kind of money for as long as I want to maintain these subtle yet meaningful aesthetic improvements.

See, no sooner had Adams plunged the last of the filler beneath my skin, my body began digesting it. Some of the Voluma in my cheeks may last for two years. The Radiesse and Vollure in my lower face, chin, and jawline may stick around for 18 months or more while the Restylane in my tear troughs will be all gone in less than a year. And I'll need to re-up on Botox sooner than I'll need to replace the hand soap in my bathroom. I'll have full forehead mobility — and the wrinkles that mobility causes — in just three to four months. I begin to wonder what I would sacrifice to be able to afford aesthetic improvements that would likely only be perceptible on a subconscious level.

I walk out of SkinSplendid assuming that, save for the Botox, I'm done. Given that I have no swelling, redness, or bruising, I stop in a friend's house who is none the wiser that I'm several notches easier to look at. The botox kicks in a few days later, and the horizontal crease lines on my forehead begin to soften. At a Christmas party, several friends tell me that I look "good," "well," and, on one occasion, "handsome." As I marvel at the compliments, it dawns on me that this — for better or worse — might just become something I do now.