The Ever Elusive... Male

Here we go again...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?” Isn’t it true that today men care more about their appearance than ever before?” 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 first went into practice 18 years ago.”

Despite the fact I have made concerted efforts to appeal to men, my practice patient population is 10% male and remains 10% male and it has never wavered.  “What am I doing wrong?” I questioned myself.  “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% of all) those undergoing non- surgical aesthetic procedures) last year were male as opposed to over 10. 6 million (91.1%) on females. That is down from 2004 when the percentage of males receiving non- surgical cosmetic procedures was 10.6% a continuing downward slope from 1997 when males made up 13.7% of all aesthetic procedures. And while the male market has increased 15% since 2014 and 260% since 1997 the female market has increased 33% and 506% respectively. The female market is growing at 2 times the rate as the male and is 10 times bigger. (1)

If my anemic percentage of male patients is substantiated by similar reports from friends plus one of the most comprehensive statistical analysis on the cosmetic seeking populous, why then the continuous talk and bombardment from a gesticulating media and industry touting a rapidly growing male market? For the media, could a PR manufactured warm -hearted piece about the evolving man be welcomed narrative?  For a wealthy aesthetic industry consumed with primarily with one gender, quite obviously there is an untapped other half of the market to develop. But for a small business owner who survives by being practical 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 a prudent decision. And even if I decide to pursue the niche of neglected males desiring beautification, is my office ready to receive the enlightened modern metrosexual male?  

Our waiting room is decorated with fresh flowers, skin care promotions, cushy couches, lighter colors, and almost always there exist 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 fresh berry infused water and offering the latest in tinted moisturizers. Most likely such an environment would be uncomfortable if not intimidating to a discreet gentleman.  I am sorry if it seems as though I am generalizing, but I do believe there is a difference between men and women. As a father of 3 daughters I can say with complete certitude my household is a lot different than the Johanssen’s at the end of the cul- de- sac who have three boys. As a student of human behavior 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 it is my educated impression that men and women have different motivations for seeking cosmetic treatments.

But first to understand my logic we are going to have to dive deeper into the male mind, and it’s not pretty, nor politically correct.  If you are easily offended you may want to stop reading here.

A-priori, humans are not as advanced as we would like to believe. Homo sapiens split off from genus homo 150 -250K year ago. The first evidence of culture 50K years ago and first cities were 8- 10,000 years ago. That means humans have been civilized for all of less than 1% of their evolution! Human brains and behaviors have been developing for eons with a solitary 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 of evolution. Humans are unique in that their primitive desires can be tempered and controlled but it would be na?ve to deny these visceral instincts of humanity exist.  There is a reason why 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 University of Florida in the early 80’s.(2) A male confederate in the quadrangle approached a random female and asked 3 questions, 1. Would you go out tonight? 2. Will you come over to my apartment? 3. Would you go to bed with me? What percentage of women do you think said yes to any of those questions? Then the situation was reversed and a confederate female went into the same quadrangle approached a random male with the same three questions. What percentage of men said yes?

It may be no surprise to you that 0% of women said yes to going to bed with a random male. However, the reverse was quite different, 75% of the men said yes to bedding an unknown inquiring female. The study concluded that the genders are wired differently when it comes to carnal desires. If the study was repeated today while the numbers may change slightly I doubt it would be by much. The primitive male mind may be quicker to accept an offer where as a female conscious is more calculating before selecting. And in a strictly primitive sense it is understandable. The consequence of conception is of greater physical and temporal burden to a female than a cruising male. Therefore, she is best off choosing a reliable, resource ample, genetically well -endowed mate. But how is she to know when the courting male is her evolutionarily matched Prince Charming.  

Today of course there are many facets that contribute to an ideal male candidate some of which are much different from our primitive ancestors. But from an evolutionary perspective a male with a strong brow, chin and cheek would be at a selective advantage to bring 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 to 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.  And 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) Furthermore, the profits of the top 25 and bottom 25 companies on the Forbes 1000 can be correlated to the facial appearances of their CEO’s. (4)  Additionally, better looking attorneys are more likely to make more money. (5) We like our male leaders tall, dominant appearing and with a full head of hair. The man looking for a competitive edge at the workplace may be open to undergoing a chin, cheek or jawline cosmetic treatment if he knew it contributed to an increase in his employment status. However, at the extreme, too prominent of a brow, chin or jaw creates a Frankenstein like appearance. It likely will strike fear, detracting a casual observer negatively impacting the response in actions and behaviors. Men born with these features may benefit from softening or maskinge fear provoking physical traits. 

Facial symmetry, evolutionarily speaking, is an outward sign of health and parasite free.  While an important denominator to the attractiveness calculus for both genders. Males in particular with symmetrical facial features might be treated to more sexual encounters with multiple women. (6.7.8) While the fleshy benefits of symmetry is good fodder for a cocktail conversation, it also may help to explain the motivation of young, recently divorced or a flirting male population of patients seeking aesthetic services.

Of course, I am just scratching the surface of the male psyche and oversimplifying. 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 then it shouldn’t come as any surprise that many men leave aesthetic offices appearing feminized ala Kenny Rogers. This likely turns off many more men and contributes to the stagnant relative growth in the male market.   

Men who seek out cosmetic surgery in my opinion do it for 3 reasons, 1. Increasing attractiveness for mate selection, 2. Tempering aggressively characterized facial features and 3. Youthful appearance to compete in the work place. If aesthetic practices are being pressured by a persuasive media and industry to cater to the male population then it will require a meaningful investment in time energy and resources to restructure offices, marketing materials and thinking.   As a few colleagues who have successfully built a male dominated practice have told me, their offices look more like a barber shop then beauty shop. To cultivate a male market we probably are better off appealing to the primitive evolutionary preserved corners of the male mind. Which is rather simple in theory but arduous and expensive in practicality. Likely it will take more than just a few brochures in the front office and a beautifully produced marketing campaign from an industry partner. If you have been unsuccessful but desiring to grow a male market of patients don’t fret, it will take a while along with a transformation in thought and action. However, in the meantime there is a rapidly expanding and ever present female population just waiting to be wowed by an impressive, reliable and honest suitor.   

-Steve Dayan, MD

1.     ASAPS

2.     Clark, R. D., & Hatfield, E. (1989). Gender differences in receptivity to sexual offers. J Psych Hum Sex, 2, 39-55

3.     Mazur A.MazurJ Military Rank attainment of a West Point Class. AmJ Sociology 1984; 90:125-150.

4.     Rule N AmbadayN. The Face of Success : Inferences From Chief Executive Officers' Appearance Predict Company profits. Psychological Science 2008 19: 109

5.     Biddle JE, Hamermesh DS. Beauty prodcutivity and discrimination: lawyers looks and lucre J of labor economics 1998;16: 172-200

6.     Gangstead S, Thornhill R. Yeo R, Ethol Sociobiol 15;73-85, 1994

7.     Grammar K, Thornhill R. J compar Psychol 108;233-242;1994

8.     Rhodes G, Proffitt F, Grady JM. Phsych Bull Rev 5;659-669.1998