Aesthetic doctors are using dermal fillers to not only reduce signs of ageing, but also make faces appear less or more masculine or feminine depending on the patient.

According to the International Society of Aesthetic Plastic Surgery (ISAPS), over 8.8 million and 1.4 million botulinum toxin and hyaluronic acid filler treatments were performed on women and men respectively in 2020, with a 24.1% increase in total cosmetic injectable procedures performed compared to 2016.

According to the American Journal of Physical Anthropology, men and women have different facial characteristics and age at different rates. While both sexes experience similar patterns of ageing, including flattened cheeks, jowling, a receded chin, and a shortened jaw height and length, women tend to age much faster than men due to menopause.

“As men and women age, they experience bone loss, fat redistribution and a reduction of collagen and elastin, resulting in the four D’s of ageing: deterioration, deflation, descent, and disproportion,” says Dr Louis Leh, aesthetic physician and medical director of Leh Clinic in Penang, Malaysia.

“In women, these changes can cause the cheeks to droop and the jaw and chin to recede, contributing to a more masculine square-shaped face. Whereas in men, ageing leads to weaker jawlines and receding chins, which can make them appear more feminine.”

In both instances, ageing results in the de-masculinisation or de-feminisation of the male and female face respectively, and this is why men and women must be treated differently.

One of the popular treatments for men and women who want to restore their youthful appearance without surgery is using hyaluronic acid (HA) dermal fillers.

Dr Louis Leh, aesthetic physician and medical director of Leh Clinic in Penang, Malaysia

“Fillers have come a long way since it first entered the market. Now, in addition to volumising depressed areas of the skin, doctors see HA fillers as a safe and effective way to reduce or reverse the signs of ageing,” says Dr Leh.

An experienced hand makes all the difference when it comes to getting filler injections. Dr Leh uses different injection methods when treating men’s and women’s faces to enhance the client’s appearance. In women, he uses what is known as the “7-point Shape technique”, where he identifies seven injection points across the face, including two points in the cheeks to achieve higher, fuller cheekbones, and five points along the chin and jawline to create a more feminine, V-shaped jawline.

In men, Dr Leh applies the “9-point Shape technique”, with two extra injection sites on the chin and upper jaw intended to lengthen and broaden the jaw and make the chin appear wider, for a more masculine appearance.

Apart from technique, selecting the right filler type is also crucial in treating different areas of the face. The filler should integrate well with surrounding skin and facial tissue, producing a natural-looking result.

“For both men and women, I typically use Juvéderm Voluma on the cheeks because it is firm enough to hold its shape and provide lift, while still being malleable enough to retain natural movement of the face. For the chin and jawline, I prefer a firmer filler like Juvéderm Volux, which is highly effective in sculpting, shaping and elongating the chin and jawline,” says Dr Leh.

Prior to undergoing any aesthetic treatment, patients should consult with a qualified aesthetic doctor, who will analyse the patient’s face and recommend the best treatment strategy which is aligned with the patient’s needs. Patient and doctor should agree on a treatment plan and outcome before proceeding with any treatment.

Before undergoing any filler treatment, a topical anaesthetic cream is applied to numb and reduce discomfort of the treatment area. Fillers such as Juvederm contain lidocaine to further minimise discomfort during the procedure.

While side effects from filler injections are uncommon, some patients can experience bruising particularly around the eyes and lips immediately after treatment. To prevent this, Dr Leh suggests avoiding vitamin E supplements, ginseng, fish oil and blood thinners for at least three days before treatment.

To ensure the best outcomes, Dr Leh advises patients to select a doctor that is LCP-certified in aesthetic medicine by the Ministry of Health (MOH) and recommends using reputable brands which are not only registered with the local health authorities, they have a proven safety profile and is supported by clinical research. Choosing a registered clinic with proper sanitisation practices is also crucial to ensure the best treatment experience.

* Dr Louis Leh is a trainer with Allergan Aesthetics.

Main photo by Dreamstime. Dr Louis Leh photo taken from Dr Leh’s website.