A Guide To Non-Surgical Facial Masculinization
For those who are transitioning from female to male or for males who wish to look more masculine, surgery isn’t the only treatment option.
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What makes a face look masculine? Research shows that a male skull is generally larger and less round than a female skull. Females tend to have softer cheekbones and a pointier chin (leading to the so-called ‘heart-shape face’), while males have more midface prominence and a squarer jaw. But all you have to do is look at the handsome mugs of Jon Hamm, Michael B. Jordan, or Henry Golding to know the question is much more nuanced. Whether you think of a strong jawline, angular nose, or heavy brow, there is no right or wrong answer other than to say there are certain facial characteristics that we consider to be decidedly masculine and feminine.
For those who are transitioning from female to male or for males who wish to look more masculine, there are key features of the face to focus on and many of them can be addressed without facial masculinization surgery (FMS). Here’s what you need to know about non-surgical facial masculinization.
The Hallmarks of a Masculine Face
Before we discuss the non-surgical treatments that can masculinize the face, we first need to revisit the initial question: What makes a face look masculine to begin with? While it can be difficult to decipher when looking at the visage as a whole, pinpointing specific features paints a clearer picture of just what constitutes a masculine aesthetic.
Let’s start at the top. “The male brow is very different from the female brow,” says Michael Somenek, MD, a double board certified facial plastic and reconstructive surgeon in Washington, D.C. who has authored and edited many works on the topic of facial masculinization and feminization. As he explains, men traditionally have a “very flat brow” that doesn’t arch laterally like a more feminized, female brow does. This, in turn, impacts the appearance of the eye. “That gives a bit of a heavier upper eyelid, which is a very sexy feature in a male,” he adds.
As the over-abundance of contouring tutorials and recent arrival of new cheek fillers would suggest, women place a strong emphasis on the midface. “We talk about cheeks all the time in females, and we build the female cheek out laterally,” Dr. Somenek shares. When you see a picture of a man with angular features, he also has definition in the midface — it’s just a different kind. It’s not “soft tissue fullness” à la Chrissy Teigen, he explains, but rather “bony definition” in the vein of James Franco or Will Smith. That treatment of volume gives angulation to this part of the face and creates a more masculine appearance.
The Nose & Lips
Once upon a time, it was determined that Kate Middleton had a “mathematically perfect” feminine nose with its 106-degree nasal tip rotation. Needless to say, the Duchess’ sniffer wouldn’t look at home on, say, Jude Law’s face. “The masculine nose, traditionally, is a stronger profile,” Dr. Somenek explains. “It’s that sort of Roman nose with a very strong dorsum and projecting nasal tip.”
Similarly, Angelina Jolie’s voluminous pout conveys a certain femininity that Idris Elba’s plush pucker does not. While the lower lip is relatively the same in males and females, the upper lip is subtly yet distinctly different. “Males have a longer cutaneous upper lip,” he shares. The cutaneous upper lip refers to the area between the base of the nose and vermillion border (where the lip turns red), and, because of the length, males tend to have a flatter upper lip.
Forgive us for saving what is perhaps the most integral facial feature for last, but we have made it to the lower face. “The main feature of a male face that people gravitate towards most of the time is the jawline,” Dr. Somenek notes. As we referenced earlier, the shape of the male and female skull differs in such a way that leads to a certain prominence of the mandible (read: jaw) and mental (i.e. chin) region. “When you see a male with a very strong, angular jawline and a strong chin, those are very masculine features,” he explains. “If you don’t accentuate those, it can create a very feminized appearance.”
Non-Surgical Facial Masculinization
Every face is as unique as a fingerprint, which means there is no one universal approach to facial masculinization. The goal of any treatment plan is to create a harmonious face that reflects the patient's desired gender and aesthetic. But, now that you have a better understanding of what is generally considered masculine, below are some of the best non-surgical treatment options to address those facial features:
For the Upper Face
Just as the shape of the male and female brow is very different, so too is treatment of it. “I have female patients coming in all the time saying, ‘I want a brow lift with Botox,’” Dr. Somenek says. “Well, you don’t want to do that with a male because you don’t want to create that subtle arching of the brow.” Instead, you want to either maintain or, for those transitioning to male, give the appearance of a flatter eyebrow. “It creates that sort of straight look where it is not arching,” he shares.
While neuromodulators like Botox® and Dysport® may not be used for a chemical brow lift, they are used to soften forehead wrinkles, glabellar lines, and crow’s feet. Generally, men do not seek the same line-effacing effect as women, but the injections can be used to relax the muscles for a subtle and rejuvenating smoothing.
For the Midface
When it comes to the midface and cheeks, it’s less about muscle relaxation with neurotoxins and more about adding volume with filler. “While we still do fill the cheeks in males, we do it a little differently,” Dr. Somenek shares. Anatomically, the cheekbones are in the same place for males and females, but how they are defined creates a masculine or feminine appearance. As he explains, the female cheek is generally filled to create both roundness and lateral width. “The cheekbone is wider than the jaw in the female face,” he explains. In males, the goal is enhanced angulation. “It’s the way that we fill their faces — more the mid-face than the lateral cheek — that makes a more masculine appearance,” Dr. Somenek says.
It’s not just the injection technique that differs. For male patients, Dr. Somenek trades hyaluronic acid-based fillers for Radiesse®, a calcium hydroxylapatite (CAHA) injectable. “Because we traditionally have thicker, hair-growing skin, I prefer a thicker filler with a more robust lifting power that is going to create a little more of the definition you want in the male face,” he explains. “Radiesse® is one of the strongest fillers out there.” Like HA fillers, it offers instant gratification with little to no downtime, though it does boast a slightly longer wear time (about one year compared to six to nine months).
For the Nose & Lips
Liquid rhinoplasty can go a long way towards creating a more masculine nose. “We can instantly take away a small hump, give you a strong profile, and even project and define your nasal tip with filler,” Dr. Somenek says, adding that it’s a “no-brainer” for those looking to masculinize the face non-surgically. “There’s no downtime except for potentially a bruise and a little bit of swelling, but you have a long-term result,” he notes.
When it comes to the lips, however, less is more. Because the male upper lip tends to be flatter, adding too much volume can look unnatural or feminine. “It doesn’t mean you can’t enhance male lips, but my recommendation is to do less volume and just subtly augment and enhance their existing features,” he shares. Rather than plumping the lip, he focuses on smoothing out wrinkled skin and adding hydration.
This becomes an even more delicate balance for those who are undergoing gender affirmation. “For someone who is looking to masculinize — a female to male patient — you can’t really do that non-surgically with dermal filler,” he cautions. “The answer is putting more filler in, which is going to feminize the lip.” As it relates to non-surgical measures, he suggests leaving the lip alone. “That’s frequently a feature that is not a dead giveaway for someone who may be looking to create one look over the other for female to male,” he notes.
For the Lower Face
Creating a more masculine jawline is, as Dr. Somenek says, multifactorial and requires a comprehensive approach that often refers back to the midface. “Unlike the female cheek where you want the cheek to protrude a little bit further than the angle of the jaw, in males, you want the midface definition to be about the same width as the jaw definition,” he explains. But that’s not all. “Males have a very distinct, acute angle of the jawline, and they also have much more projection to the chin,” he adds.
All of these factors should be taken into account when developing a treatment plan for the lower face. “There are several ways, non-surgically, you can create more definition,” he shares. Needless to say, filler is a big one. “It's instant gratification, it lasts you a reasonable amount of time, and you can walk out with a jawline you never thought you were capable of having,” Dr. Somenek says, adding that he often prefers chin filler to a chin implant due to the quality of the result and the relative ease of maintenance.
With age, skin laxity can soften an otherwise strong jawline, which non-surgical skin tightening can correct. “FaceTite™, which is a radiofrequency (RF) treatment that is minimally invasive, can really tighten the chin along the jawline,” he notes. Radiofrequency technology — whether it’s RF microneedling, sub-dermal radiofrequency, or one of the other modalities on the market — have shown a lot of promise in toning and tightening and can be used to strengthen the jawline for a masculine effect.
Another area of concern? “Everyone has that little fat pad under the chin,” Dr. Somenek says. Removing it can go a long way toward defining the chin and jaw. Non-surgically, you may be curious about Kybella®. The injectable is an FDA-approved treatment for submental fat, but it is not particularly popular at Dr. Somenek’s practice. “When you look at the logistics of Kybella® — two to three treatments spaced three to four weeks apart, a ‘bullfrog’ appearance for three to five days each time, numbness for weeks, and, at the end of your journey, you might still want more — it becomes very cost-prohibitive,” he explains.
While it is a surgery, submental liposuction can be an attractive alternative. As Dr. Somenek describes, it's a 45-minute procedure performed under local anesthesia in the office. It has what he calls a “limited recovery” and offers permanent fat removal in one session. For these reasons, most of his patients opt for liposuction over Kybella®.
Non-surgical facial masculinization procedures can be performed in unison or over time. “You can stage it however you would like, but I like to prioritize whatever areas the patient would like to address first,” Dr. Somenek says. “We can tackle it all at once, but, if it’s a budgetary or comfortability concern, we can target one area at a time.” It should be noted that, for patients who are interested, considering a treatment plan that blends surgical and non-surgical procedures may yield the best result. “That is truly going to maximize their appearance,” he shares. “It’s going to give them the most definitive, long-term result for themselves.” Consulting with a board certified plastic surgeon who specializes in treating men will ensure you receive the best care for your aesthetic goals.
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