How to Cheat Age in the Age of Bro-tox

By Josh Dean

You’re aging. It happens. And lucky for you, the cosmetic tools to hide it are no longer reserved for ladies and plastic-faced newscasters. More men than ever are fixing their faces with lasers, needles, and chemicals. Suddenly the ever shifting line between what’s sensible and what’s shameful is getting tough to see (unlike those lines on your forehead). Injections of neurotoxins? Maybe a dollop of fake collagen? Are we really doing that now? Josh Dean on saving face while, you know, saving your face.

Here, in the sparkling, spa-like office of one of Manhattan’s finest dermatologists, I realize I am taking my first tentative steps onto an awfully slippery slope. Michael Eidelman, M.D., is 46 but looks ten years younger, a fact that is criminally under-utilized in the marketing of his practice, considering that his fresh-looking, tastefully unlined face is at least partly the result of Botox that he administers himself, using a syringe in the mirror. This is not the kind of Botox that you notice, the kind that paralyzes every facial muscle, rendering any expression except that of a stupefied newscaster impossible. No, this is a far more subtle application; I’d say it looks natural, except that it isn’t at all.

We are only in the very early days of the Era of Unapologetic Male Beauty, and Eidelman, a dermatologist specializing in noninvasive cosmetic procedures, is something of a pioneer. While the so-called aesthetic medicine he practices—this tinkering with muscle, fat, and skin to combat aging—has traditionally been used exclusively by women, men are now increasingly turning to it in search of eternal youth, or at least an arrested version. Today, roughly 40 percent of Eidelman’s clients at Chelsea Skin & Laser are guys, and he has thrice addressed national physicians’ conferences on this phenomenon of male beautification, giving talks entitled “Bro-tox” and “Menaissance.” The techniques men are trying span a gamut, from eyebrow sculpting to teeth whitening to high-tech procedures that’ll either grow hair where it’s wanted or laser-blast it away from where it’s not. Indeed, if Eidelman’s own busy office is any indication, the sort of procedure that once might have sounded outlandish for many guys is now beginning to sound more like routine upkeep. “What I’m seeing more now is, like, a straight stockbroker who just wants to look good,” Eidelman tells me. “These people would never have come in before. They’re taking care of their bodies, and they know it’s not a big deal.”

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The number of men seeking Botox has increased 310 percent since 2000, according to the American Society of Plastic Surgeons, and a similar boom is happening with other noninvasive procedures like filler and laser treatments. These days you can even erase your paunch by freezing away fat cells. Combine the availability of easy outpatient treatments with wider cultural acceptance and an increased emphasis on the value of youth in the workforce and what you’ve got is the makings of a mini-revolution.

At Eidelman’s office, he often delivers a suite of treatments that includes fillers like Restylane, Juvéderm, and Sculptra to reverse sunken eyes and cheeks, and intense pulsed light (or IPL), which reduces sun damage and red spots from broken blood vessels. Some patients get one or two; others go whole hog. Me? I’m not sure. I hate aging as much as the next guy, and it will probably take great resolve one day to curb the urge to dye my hair when salt overwhelms pepper, but I’m also kind of scared of needles and terrified of looking like some kind of plasticized freak or, worse, a newscaster. Eidelman understands. He’s a kind person with a pleasant manner. He somehow doesn’t seem at all insulting when, within minutes of my arrival for a consultation, he begins to pick apart my flaws.

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He had asked me to bring along a picture of myself ten years ago, when I was 30, and that photo—featuring a brighter-eyed, less gray version of myself somewhere on the Inca Trail in Peru—stares eagerly back at me from a tray next to the exam table where 40-year-old me is clutching a hand mirror.

"Every face is individual," Eidelman says, standing over my shoulder and looking for areas where my face has aged. "Much as it is a science, there’s an art to it, too." The treatments he suggests will be administered in an iterative process while Eidelman perfects "the recipe" for a regimen that will be repeated two or three times a year. One advantage of a doctor like Eidelman who specializes in these cosmetic treatments—as opposed to a mere family doctor who dabbles in them, or the staffers in the strip-mall Botox factories you find in affluent exurbia—is his careful attention to detail. We both notice the heavy lines on my forehead, and he begins to poke and pull at them, stretching the skin and then allowing it to slacken and fall back into place. He could smooth those lines with Botox, though one risk of overdoing it is making the brows so heavy they droop. "We can do some softening in that area and create a natural look," he explains. Occasionally patients come in and demand to erase all lines. And in those cases, he tells them they’ll ultimately start looking pretty tired. "Then you end up with an effect like this," he says, and pushes my forehead skin downward, giving me the sad eyes of Droopy Dog.

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Eidelman continues with his lesson in the anatomy of facial muscles and the savvy application of neurotoxins. He points out the crow’s-feet near my eyes. “That’s from smiling, which is a good thing,” he says, and he zeroes in on my glabellar wrinkles, a.k.a. “the eleven,” those two lines that form between the eyebrows. All can be fixed. “You also look like you have some sun damage,” he says, pointing at the freckles and other dark spots that have clustered on my cheeks in increasing density over the years. That could be cleared up with the IPL treatment.

He picks up my photo. “What I notice is that your cheek has changed a little bit in its shape, and your chin.” This is a very typical change that occurs with aging, as we lose some of the fat that used to hold the cheeks up. In men, it also tends to happen under the eyes and at the temples. The result is a visage that can appear limp. To provide some smoothing and lift to my features, Eidelman says, he can use a filler that he injects just below the surface to make up for some of the volume I’ve lost over the years.

I’ve been with him through the neurotoxin injections and the light treatment, but something about the fillers—about inserting under my skin a viscous gel that I’d likely need to replenish in a few months—makes my stomach jump, and Eidelman senses it. “Usually the fillers are not something we do on the first visit,” he says, patting me on the shoulder. Fillers take longer to administer and tend to cause some redness and swelling. But every person reacts to treatments differently. Some patients go straight back to work. “You have to get to know a person to see how they do.”

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Eidelman hands me back my picture. The options are a lot to process, and what surprises me isn’t that I’ve taken the critiques of my face in stride. It’s that some of these things seem easy and painless enough that I’m seriously considering going through with them. “Don’t worry,” Eidelman tells me, “I wouldn’t do anything to you that I wouldn’t do to myself.”


I am not a terribly vain person, which is different from not being vain at all. I feel few societal pressures to be prettier or younger. My job as a writer doesn’t require it, and I’m married, which means my wife is legally bound to be attracted to me, or at least pretend. The thought that I might be too old for anything has honestly never entered my mind, not even when it should, like when I’m snowboarding or playing pickup basketball with teenagers.

Then I turned 40—a symbolically fraught age that always seemed impossibly distant—and began to notice the effects of growing older more clearly. Suddenly I was the age of baseball coaches, not baseball players. This should be fine; after all, the culture has long accepted us guys wrinkles and all. But at some point, maybe when husbands began to see the simple improvements their wives have undertaken for eons—or perhaps when Simon Cowell admitted that he was such a youthful 53 because his beauty regimen included a few hundred push-ups per day, lemon bath milk, and Botox—guys have begun to unabashedly chase the dragon of youth, too.

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"I think men are starting to realize you can get this stuff done without looking like you had it done," says Cliff Kohler, a 38-year-old retired Air Force captain who now works in the pharmaceutical industry. "People say, ‘Oh, you look so much more rested.’ "

Kohler got his first Botox injection when he was 26 and has since added regular filler treatments under his eyes. He’s recently come back from a job interview in Texas and tells me the interviewer used the word youthful at least four times. When the economy tanked, Kohler says, numerous friends sought treatments precisely because of the tightened market. “They wanted to look younger.”

Those guys were ahead of the curve. In Silicon Valley, where Mark Zuckerberg’s pronouncement that “young people are just smarter” has been adopted as a foundational tenet, the pressure to appear youthful is crushing, says Vic Narurkar, a San Francisco dermatologist who told me he’s seen a “significant increase in men looking for appearance-enhancing procedures in the last three or four years.”