I recently fielded a call from a budding reporter. “Dr. Dayan, would you be willing to comment about the upsurge in men seeking cosmetic treatments? Don't you believe there is an increased sensitivity and vanity in the modern evolved man?” My uncomfortably long pause prompted her to reengage, “Dr. Dayan are you there, Dr. Dayan….?”
I was slow to speak because my answer was the same to this reporter as it was to her ancestral bookend a decade ago. “There really hasn't been a significant change in the number of men seeking cosmetic treatments in my practice since I started practice 18 years ago.”
A Woman's World
Despite the fact that I have made concerted efforts to appeal to men, my practice patient population is 10 percent male, and it has never wavered. “What am I doing wrong?” I questioned. “Am I the only one who is experiencing a similar stagnant male patient growth?” After a bit of reflection, conferring with a few colleagues, and research, I stumbled across a few interesting tidbits. According to the latest statistics published by the American Society of Aesthetic Plastic Surgeons (ASAPS), 1.036 million (8.9 percent) of all those undergoing non-surgical aesthetic procedures last year were men, compared to more than 10.6 million (91.1 percent) women. That is down from 2004 when the percentage of men receiving non-surgical cosmetic procedures was 10.6 percent, and a continuing downward slope from 1997 when males underwent 13.7 percent of aesthetic procedures. And while the male market has increased 15 percent since 2014 and 260 percent since 1997, the female market has increased 33 percent and 506 percent, respectively. Put another way: The female market is growing twice as quickly as the male market and is 10 times bigger.1
So why the continuous talk and bombardment from media and industry about a rapidly growing male market? For a wealthy aesthetic industry consumed primarily with one gender, there is an untapped other half of the market to develop. As a small business owner, I have to question if devoting precious resources, attention, and time to pursuing a male market of patients that is 10 times smaller and growing at half the rate as the female market is prudent. And if I decide to pursue the niche, is my office ready for the modern metrosexual male?
Consider that our waiting room is decorated with fresh flowers, skincare promotions, cushy couches, lighter colors, and almost always occupied by a stylish woman (or two) accompanied by a designer bag with recently purchased boutique clothing. Our guests are greeted by a young female host serving berry-infused water and offering the latest in tinted moisturizers. Most likely such an environment would be uncomfortable, if not intimidating, to a male patient. I am generalizing, but I believe there is a difference between men and women. There is no doubt that appealing to primitive visceral instincts in both men and women is a successful strategic tactic to altering behavior or stimulating action, and as a student of human behavior, it is my educated impression that men and women have different motivations for seeking cosmetic treatments.
A-priori, humans are not as advanced as we would like to believe. Homo sapiens split off from genus homo 150,000-250,000 years ago. The first evidence of culture was 50,000 years ago, and first cities were built 8,000-10,000 years ago—humans have been civilized for less than one percent of their evolution! Human brains and behaviors have been developing for eons with the mission to find an ideal mate, procreate, and ensure genetic reign. Humans think and behave in a way that is meant to survive the harshest environments. Humans are unique in that their primitive desires can be tempered and controlled, but it would be naïve to deny that these visceral instincts of humanity exist. There is a reason humans shy away from a growling animal, favor fertility, and desire the quick hit of energy found in a packet of sugar. Mother nature doesn't make mistakes.
In a frequently cited study done at the University of Florida in the early 80s,2 a male confederate in the quadrangle approached a random female and asked her three questions: 1.) Would you go out tonight? 2.)Will you come over to my apartment? 3.)Would you go to bed with me? Then the situation was reversed and a confederate female in the same quadrangle approached a random male with the same three questions.
It may be no surprise that no women said yes to going to bed with a random male. However, 75 percent of men said yes. The study concluded that the genders are wired differently when it comes to carnal desires. If the study were repeated today, the numbers may change slightly. The primitive male mind may be quicker to accept an offer, whereas the female conscious is more calculating before selecting. In a strictly primitive sense, this is understandable. The consequence of conception is of greater physical and temporal burden to a female. Therefore, she is best off choosing a reliable, resource-ample, and genetically well-endowed mate. But how is she to know when the courting male is her evolutionarily matched Prince Charming?
Many facets contribute to an ideal male candidate, some of which are different from those of our primitive ancestors. From an evolutionary perspective, a male with a strong brow, chin, and cheek is at a selective advantage to bringing home a meal. Such a well-shielded hunter would appreciate the eye and neck protection their facial skeleton would provide when fighting off a foe or beast. And the primitive decoders in the human amygdala subliminally identify these physical features as attractive. It is not random that all heroes from Superman and Batman to Brad Pitt and Dwayne “the Rock” Johnson project a dominant facial skeleton. Men not blessed with a strong aquiline jaw or chin can temporarily compensate with facial hair or a goatee or more permanently remedy with facial fillers/implants. The overwhelming evidence points to them doing it for good reason. Male cadets at West Point with dominant facial features achieve higher military rank in their senior year and in their profession.3 Profits of the top 25 and bottom 25 companies on the Forbes 1,000 correlate to the facial appearances of their CEOs.4 And, better-looking attorneys are likely to make more money.5
The man looking for a competitive edge at the workplace may be open to undergoing a chin, cheek, or jawline augmentation if he knew it contributed to an improvement in his employment status. However, at the extreme, too prominent of a brow, chin, or jaw creates a Frankenstein-like appearance, striking fear and negatively impacting response. Men born with these features may benefit from softening their fear-provoking physical traits.
Facial symmetry, evolutionarily speaking, is an outward sign of health and an important denominator of the attractiveness calculus for both genders. Males with symmetrical facial features might be treated to more sexual encounters with multiple women.6-8 The fleshy benefits of symmetry may help to explain the motivation of young, recently divorced or single male patients seeking aesthetic services.
Of course, not all males are the same, but generalizations are component to developing markets and to appealing to the majority of those seeking a product or service. And if we treat men and women the same, appeal to them with the same advertisement, assume that they are interested in the same things, and use the same techniques and products on them, it shouldn't come as any surprise that many men leave aesthetic offices appearing feminized (a la Kenny Rogers). This likely turns off many men and contributes to the stagnant relative growth in the male market.
Men who seek out cosmetic surgery, in my opinion, do it for three reasons: 1). Increasing attractiveness for mate selection, 2.) tempering aggressively characterized facial features, and 3.) maintaining a youthful appearance to compete in the work place. As a few colleagues who have successfully built a male-dominated practice have told me, their offices look more like a barber shop than beauty salon. To cultivate a male market, it will take more than just a few brochures in the front office and a beautifully produced marketing campaign from an industry partner to fully engage male patients. If you have been unsuccessful but desiring to grow a male market of patients, don't fret. There is a rapidly expanding and ever-present female population just waiting to be wowed by an impressive, reliable, and honest suitor.
1. American Society for Aesthetic Plastic Surgery, 2016 annual statistics.. https://www.surgery.org/sites/default/files/ASAPS-Stats2016.pdf
2.Clark, R. D., & Hatfield, E. Gender differences in receptivity to sexual offers. J Psych Hum Sex, 1989;2, 39-55
3.Mazur A. Mazur J. Military Rank attainment of a West Point Class. Am J Sociology 1984; 90:125-150.
4.Rule N, Ambaday,N. The Face of Success: Inferences From Chief Executive Officers' Appearance Predict Company profits. Psychological Science 2008 19: 109
5.Biddle JE, Hamermesh DS. Beauty, Productivity and Discrimination: Lawyers' Looks and Lucre. J Labor Economics. 1998;16: 172-200
6.Gangstead S, Thornhill R. Yeo R, Ethol Sociobiol. 1994: 15;73-85
7.Grammar K, Thornhill R. J Vompar Psychol. 1994; 108;233-2428,
8. Rhodes G, Proffitt F, Grady JM. Phsych Bull Rev. 1998; 5;659-669