When should I start getting Botox®? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do-over”? Do I really need to, as the saying goes, sacrifice my butt for my face? Should I swap my temporary dermal fillers for something a bit more permanent?
When it comes to beauty and aesthetics, there is no such thing as one-size-fits-all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, Coming of Age, The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.
As men enter their forties, visible signs of aging creep in. Gray and/or thinning hair is common (hey, George Clooney proves there is nothing wrong with a little salt and pepper!), as are fine lines and wrinkles, skin laxity, and weight gain (to name a few). So, what’s the best way to address these newfound concerns? Top plastic surgeons and dermatologists share the best cosmetic procedures and treatments to help men in their forties look their best.
Turning Back the Clock
Remember those shifts in your skin, hair, body that you started to see in your late thirties? Well, they further reveal themselves in this decade. Men in their forties experience changes in muscle mass, metabolism, elasticity, and hair density, while any stress- and sun-induced damage you accumulated earlier in life makes its grand debut (think: hyperpigmentation, fine lines, and wrinkles).
Fortunately, more guys than ever are realizing that you don’t have to accept these changes as a fact of life. “With the increasing popularity of cosmetic procedures, more and more men are taking notice that preventative and restorative therapies are the key looking and feeling youthful,” says Nima Naghshineh, MD, a board certified plastic and reconstructive surgeon in Pasadena, CA.
It should come as no surprise that body contouring and skin resurfacing are among the most popular. “Preventative measures, like body muscle toning and neuromodulators to soften expression lines are very popular, while restorative treatments for skin tightening and laser resurfacing for sun damage and texture correction are becoming increasingly utilized by men to help turn back — or at least pause — time,” he adds.
The Best Cosmetic Procedures for Men in Their 40s
From professional and at-home skincare to face and body contouring procedures, here are some of the best treatment options for men in their forties.
Before we dive into all the professional treatments that exist, we must reiterate the importance of a quality at-home skincare routine. As outlined in our guide to men’s skincare in their forties, your daily regimen should include a cleanser, antioxidant serum, moisturizer, sunscreen, and, now, a retinol or retinoid.
Antioxidants (think: vitamin C and vitamin E) can help combat the effects of oxidative stress (i.e. free radicals from the sun that cause cellular and tissue damage), while a topical vitamin A derivative (in the form of a retinol or retinoid) can increase cell turnover to improve tone and texture. About as close to a superhero ingredient as they come, be mindful of sensitization when beginning a retinol or retinoid routine. To prevent irritation, use only a pea-sized amount twice a week to start. As your skin begins to tolerate it, you can add additional nights. Remember, it’s meant to be a treatment, not a moisturizer.
Professional Skincare Treatments
If you’ve been following this series, you know we’ve discussed the benefits of regular professional skincare treatments in the twenties, thirties, and, yes, now the forties. In fact, it’s less about radically altering your routine and more about augmenting it. The sweet spot for skin resurfacing? Quarterly medium-depth chemical peels, monthly light peels, and annual ablative laser treatments, says Jason Emer, MD, a board certified cosmetic dermatologist in West Hollywood.
He recommends chemical peels to patients at every stage of life, but forty-something men can up the potency for more dramatic results. Depending on the person’s skin concerns, the RevePeel Enlighten Rx Depigmentation System or a TCA peel can be used to improve skin tone and texture.
When it comes to lasers, Dr. Emer says yearly sessions with a CO2 or erbium device is the key to preventing deeper wrinkles from taking hold, while coming in for Halo™ or Moxi treatments (with or without BBL Hero®) every three to four months can regularly treat sun damage, pre-cancerous spots, and wrinkles. If someone has specific areas of wrinkling — like the under the eyes or around the mouth — the Plasma Pen™ or a spot treatment of a ProFractional™ laser can be added on to target them. Dr. Nima likes the Opus Plasma™, a micro-ablative fractional technology, to resurface and remove layers of sun damaged skin because it has less downtime.
Injectable neurotoxins (read: Botox®) and dermal fillers can be a great way to rejuvenate the face sans surgery, but a patient’s previous treatment protocols will dictate how they are used. When it comes to Botox®, it will soften wrinkles at any age, but men that are experiencing sagging skin should tread carefully. “At some point, Botox® would be less effective — not as an injection but as a technique,” Dr. Emer explains. The reason? “You don't want somebody to have hooded eyebrows or heavy lids,” he says. Instead, patients with loose skin may instead consider surgery (more on that below!) for a longer-term solution.
In your forties, you will likely start to see a loss of volume in the midface, but it’s not just about plumping the skin up with filler. “When you talk to your doctor, you need to address sagging and tightening separately,” Dr. Emer cautions. “You don't use fillers to lift because fillers are not made to lift.” In fact, when filler is used to lift, the result tends to “look overdone,” he says. That’s not to say, however, that filler can’t serve a purpose. “[Filler is] made to enhance a feature, fill a line, and volumize areas,” Dr. Emer notes. As such, collagen-producing fillers, like Sculptra®, can be used to contour midface hollows, temples, along the jawline and chin, or to rejuvenate the hands.
As an alternative to traditional dermal filler, fat grafting and fat-stimulating injectables, like Renuva®, are natural ways to restructure the face — not just fill it. “Instead of doing fillers over and over in areas where you might have low volume, like a cheek or a fold, this actually gets injected and the matrix proteins build overtime, creating new fat cells and new volume in that area,” Dr. Emer explains.
It’s time to talk sagging and laxity. To firm and tighten the skin, Dr. Emer recommends radiofrequency-based treatments like Morpheus8 (which combines microneedling and radiofrequency), Fractora (to minimize the appearance of superficial scars), and Forma. Because you are beginning to visibly see the breakdown in elasticity at this stage, you’ll actually see immediate results from these cosmetic treatments. “It contracts the tissue underneath, and you get new collagen production,” Dr. Emer notes.
For patients with advanced cases of sagging who aren’t ready to go under the knife, FaceTite may be the ideal solution. “It is a probe that goes under the skin to shrink wrap it,” Dr. Emer explains. “It does jawline, neck, and lower face defining.” As he explains, it can be used for people who don’t want a facelift or neck lift, or it can be paired with submental liposuction to refine the jawline.
By the time you reach your forties, surgical procedures may provide more dramatic and longer-lasting results. One of the first areas of the face to show advanced signs of aging is the eyes. “Men are noticing some hooding or extra skin on their upper eyelids and start enquiring about upper lid blepharoplasty,” says David Shafer, MD, a New York City-based double board certified plastic and reconstructive surgeon. Additionally, brow lifts can help to rejuvenate aging and tired eyes.
Surgical procedures that enhance and contour the face, like cheek implants and jaw implants, can be considered if/when filler maintenance becomes too much. Annual or semiannual thread lifts, meanwhile, continue to be a less invasive sculpting option. Dr. Emer likes to combine threading with Sculptra® and Morpheus8 for a multipronged, collagen-stimulating treatment that can reduce sagging and tighten the skin around the face and neck.
If a double chin is getting in the way of your ideal neck and jawline, liposuction can remove the excess fat. “Submental fullness is also a growing concern for men in their forties, and neck liposuction offers a fast and permanent way to restore a defined jawline,” Dr. Shafer shares.
“Men in their forties are definitely noticing their dad bod,” Dr. Shafer says. “While some embrace their new gut, many are coming into our office searching for options to reduce their love handles and abdominal bulges.” Liposuction is perhaps the most well-known way to remove excess fat, and he says the love handles, lower back, abdomen, and chest are popular treatment areas during this time.
Speaking of the chest, Dr. Shafer also notes that it tends to be the decade men are ready to address gynecomastia (a.k.a. male breasts). “Men are finally coming to terms with the fact that their gynecomastia is not going away or they are seeing more chest fullness from weight gain and looking for surgical options to remove the chest fat,” he explains.
But surgery isn’t the only solution. CoolSculpting® quite literally freezes away unwanted fat, while strengthening procedures like Emsculpt® allow guys to build and improve muscle tone in a way that complements and maximizes their current fitness routine.
Whether you’ve been experiencing hair thinning for years or it’s a more recent development, surgical and non-surgical hair restoration is quite common for men in their forties. Dr. Emer notes a surge in guys seeking hairline lowering and hair transplant procedures (for both the scalp and eyebrows), and Dr. Shafer often recommends platelet-rich plasma (PRP) injections as a first line of defense. In the latter, blood is drawn (likely from the arm), put in a centrifuge to concentrate the growth factors, and then injected into the desired area. Curious? Read more about one patient’s experience with PRP for hair loss.
Last but not least, we’d be remiss not to mention sexual wellness. “No matter the age group, men are interested in their manhood,” Dr. Shafer says. He offers the so-called ‘SWAG’ (Shafer Width And Girth) penile enhancement, which involves injecting a hyaluronic acid-based filler into the penile shaft and glans to increase penis girth and length. During a P-Shot treatment, meanwhile, PRP can be injected to the head and specific parts of the penile shaft to treat erectile dysfunction and generally improve sexual health.
Throughout your forties, you’ll likely notice changes to your skin (hi, wrinkles and sagging), hair (where has that hairline gone, anyway?), and body (your metabolism isn’t as quick as it used to be) that can be treated with an array of surgical and non-surgical aesthetic procedures. Consulting with a board certified dermatologist or plastic surgeon who specializes in men will help you to develop the best treatment plan for your needs.
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