The public's common image of a Botox patient is a middle-aged woman hoping to look more youthful through the minimally invasive procedure.
But plastic surgeons say that "brotox" - the use of Botox by men - is gaining in popularity.
Between 2000 and 2010, there was a 258% increase in the number of men undergoing treatment with botulinum toxin type A, according to the American Society of Plastic Surgeons.
In fact, more men in 2010 chose Botox treatment than any other form of cosmetic surgery or enhancement, the society reported, with 336 834 males receiving shots of the toxin to relax muscles and deaden nerves to improve their appearance.
No more stigma
"I think the stigma of it to men has dropped," said Dr Stephen B. Baker, an associate professor and programme director of the department of plastic surgery at Georgetown University Hospital in Washington, DC. "These days, you can get it done everywhere but a gas station, and maybe in some states even there."
Men tend to use Botox to smooth out a furrowed brow that otherwise makes them look angry, said Baker and Dr John Sherman, a clinical assistant professor of surgery at the Weill Cornell Medical College in New York City.
"Most of the men, what bothers them is the forehead wrinkles and the wrinkles between the eyebrows," Sherman said.
However, the doctors agreed that men tend to request spot treatment for smoothing of specific facial details whereas women tend to want a complete makeover.
"Men want a little more subtlety than women," Sherman said. "They want movement of the face, but they don't want deep furrows in their forehead."
Men prefer Botox to surgery
Men also tend to prefer Botox because the effects are temporary, lasting only three to four months, Sherman added. "The nice thing about Botox is, it wears off," he said. "It's reversible, so if you have a complication it's not forever. It's not like surgery."
Marcus Gogas, 49, of Alexandria, Va., had Botox treatment for the first time two years ago. A senior investigative analyst for the Internal Revenue Service, Gogas is an actor on the side and said he wanted to freshen up his looks. He found Botox an attractive option because it's an outpatient procedure and didn't seem as extreme as actual plastic surgery.
"I'd seen bad plastic surgery," Gogas said. "You see people on TV, and they don't look like who they were. I didn't want any drastic changes."
He had deep creases in his forehead smoothed out and also had crow's feet removed from around his eyes. He's since gone back every eight months or so for new treatment.
"For me, I just like the way I feel," he said. "I don't want plastic surgery. This is a great way for me to look good, feel good and feel refreshed, and it's affordable for me. Also, there's no downtime. You can go about your day, and as the days go on you see the effects."
The most common complications are small red bumps or bruises where the shots are given, but those generally fade quickly. The Botox shots take effect in four or five days, and some men have to go back at that point for a touch-up if one side of the face has responded better to the shot than the other.
"This is a pretty easy thing," Baker said. "There aren't a lot of complications to it. It's like getting a cavity filled."
A-Z of Botox
The American Society for Dermatologic Surgery has more on Botox treatment.
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