What’s Actually Different About Treating a Man’s Face

About 35% of our patients here are men. That number is higher than most practices report, and it’s still lower than it should be.

We sell every treatment in this article. What I want to do is explain what genuinely changes when the face being treated is male — because the honest answer isn’t “different treatments.” It’s the same treatments, dosed and placed differently, and most of the industry could educate on this more thoroughly.

Why do men need more neurotoxin?

Because the muscles are bigger.

The definitive work here is old and still holds. Carruthers and Carruthers ran a randomised, double-blind, dose-ranging study in 80 men with glabellar lines, assigning 20, 40, 60 or 80 units of onabotulinumtoxinA. Twenty units — the standard female dose, and the dose on the label — was frequently inadequate. Response improved substantially at 40, 60 and 80.

A 2024 review in Dermatologic Surgery summarises where the field landed: men often require roughly double the standard female dose in the glabella, driven by greater procerus and corrugator mass. A 2025 cross-sectional analysis put numbers on it in practice — men received significantly more units in the procerus, 7.7 versus 5.7 on average.

Fact vs. Fad: “Men need more units” is true on average but inaccurate as a rule. That same Dermatologic Surgery review is explicit that not all men require higher doses, and that escalation should be reserved for those with genuinely prominent muscle mass. I dose the muscle in front of me, not the box on the intake form. A slightly built man with a modest corrugator gets a modest dose, and a woman with a powerful frown gets more than the label suggests. Sex is a prior, not a prescription.

Why shouldn’t a man’s face be frozen?

This is the point I care most about, and it isn’t vanity — it’s function.

Men communicate with the upper face. The brow does a great deal of conversational work: emphasis, scepticism, agreement, the small raise that signals you’re listening. Take that away and the result reads as flat rather than rested. Patients notice it in themselves and colleagues notice it without being able to say why. This can apply to all sexes in certain fields where expression is part of the job and needed to communicate effectively.

There’s an anatomical reason it goes wrong more easily in men. The male brow sits lower and straighter, without the lateral arch that’s typical in women. The Dermatologic Surgery review flags the frontalis specifically as requiring precise dose and placement in men to avoid brow ptosis — because a brow that starts lower has less room to drop before it looks heavy.

So my approach in the upper face is to soften rather than abolish. I’d rather you still furrow and have a faint line at maximum effort than have a smooth forehead and a face that’s stopped talking. That’s a deliberate undertreatment relative to what some patients ask for, and I’ll say so at the consultation.

Is men’s skin actually different?

Meaningfully, yes — and it changes what I recommend.

Androgens drive it. Male facial skin is measurably thicker — high-frequency ultrasound across 118 adults put the forehead dermis at 1.17mm in men against 0.86mm in women, and the same gap holds at the glabella, the temple and the cheek. Sebaceous glands are more active and pores are larger, so male skin is oilier and more congestion-prone well into middle age. And the male dermis is more vascular.

Three practical consequences.

Thicker, denser skin holds up better early — men often look younger than female peers into their thirties — then tends to show deeper lines when it does go, rather than fine ones. That favours treatments that work at depth over surface-level ones.

Oilier, larger-pored skin means congestion and texture are common presenting complaints, and it responds well to peels and proper cleansing protocols that lighter skin wouldn’t tolerate as often.

And higher vascular density means more bruising. If you’re having filler before something that matters, build in more recovery time than a female friend would need. That’s not a caution I see written down much and it’s the one men complain about most.

Do men get different treatments?

No. Same menu, and I want to be blunt about this because the “men’s treatment” framing is largely marketing.

Botox is Botox. Filler is filler. A laser doesn’t know whose skin it’s aimed at. There is no separate male product line with different pharmacology, and a clinic charging a premium for a “men’s” version of a standard treatment is selling you packaging.

What changes is dose, placement, and what we’re trying to achieve. That’s not a small distinction — it’s the entire distinction — but it lives in the judgement of the person injecting, not in the product on the shelf.

Why does filler placement differ?

Because masculine and feminine facial proportions genuinely diverge, and filler placed to a feminine template on a male face is the single most common way this goes wrong.

The pattern is measurable. That same 2025 cross-sectional study found men required significantly greater hyaluronic acid volumes in the mandible, while women received larger volumes in the lips, chin, pre-jowl and under-eye regions. That maps onto what masculinity reads as: a wider, squarer, better-defined jaw, a flatter brow, an angular rather than rounded transition from cheek to jaw.

The classic error is over-filling the mid-face. Anterior malar projection — that high, forward cheek — is a feminising feature. Build it on a man and he won’t look younger, he’ll look subtly wrong in a way neither of you can name. Male filler usually wants to go lateral and low: jawline, angle of the mandible, chin projection, temples where hollowing has flattened the upper face.

The goal isn’t a softer version of a man’s face. It’s a more defined version of it.

Why are men still underrepresented?

Some of it is residual stigma, and that’s fading faster than people think. More of it, in my experience, is that men present later — often after someone else suggested it, and usually with deeper lines that would have been easier to treat earlier.

There’s also a reasonable fear underneath it, which is looking obviously done. Men are the patients most likely to say “I don’t want anyone to know,” and I take that seriously as a treatment goal rather than as an anxiety to be talked out of. It’s also why the undertreatment point above matters: the way to keep a result invisible is to aim for less than the maximum the muscle would tolerate.

At this practice, you choose your provider when you book, and the provider you choose is the one who treats you. Injectables are performed by our physicians and our advanced practice nurse; laser hair removal for men and facials are performed by our licensed medical aestheticians.

References

Carruthers A, Carruthers J. Prospective, double-blind, randomized, parallel-group, dose-ranging study of botulinum toxin type A in men with glabellar rhytids. Dermatologic Surgery. 2005;31(10):1297–1303.

Neuromodulators in men. Dermatologic Surgery. 2024. PMID: 39196837

Hyaluronic acid fillers and botulinum toxin type A: cross-sectional analysis for optimizing outcomes based on sex and age. 2025.

Meng Y, Feng L, Shan J, Yuan Z, Jin L. Application of high-frequency ultrasound to assess facial skin thickness in association with gender, age, and BMI in healthy adults. BMC Medical Imaging. 2022;22:113. doi:10.1186/s12880-022-00839-w (cross-sectional, n=118)