“How old do you give me?” asks Laurent, one of the three Apollons waiting on this November morning, seated in the waiting room under a crystal chandelier and surrounded by marble furniture. The man, round and smooth, clean-shaven, founded a successful telecommunications company. He is the leader and the showcase. It is his face that his clients see before putting their hands on the stock market. It is his face, again, that his 100 employees dissect during each interview or team session. Let it fade? Unthinkable.
To “stay in the game”, Laurent has Botox injected by a cosmetic surgeon in this office Haussmann style in the heart of the chic 6th arrondissement of Marseille. Introduced in small quantities, botulinum toxin, also responsible for botulism (a serious neurological condition), paralyzes the muscles responsible for wrinkles and folds by disconnecting them from the nervous system. After the injection, the manager’s brow tenses and the years fade: “I was told I was 35”, struts this self-proclaimed macho who wants to be as “manly” as he is flirtatious. He is 51.
Developed late and booming in recent years, aesthetic medicine – that is, everything that does not involve the surgery of the same name – is attracting more and more men in the wake of its success. Even if there is no official register, representatives of the sector estimate that the share of men in their clientele has doubled since the health crisis, going from 10% in 2019 to more than 25% today. A phenomenon driven by new ways of understanding masculinity and appearance.
Pay for the head of the job
Unlike women, with more diverse social origins, men who retouch are for the most part executives, senior managers or team leaders who want to offer themselves or maintain “the head of the job” after their forties, without taking the step of surgery. “More than looking younger or more beautiful, they want to avoid being marked, appearing tired or worried, so as not to be sidelined,” explains surgeon Adel Louafi, president of the National Surgery Union. reconstructive plastic (SNCPRE).
Laurent asked for the first injection ten years ago, after a divorce. “At my age, some people wear the misery of the world on their faces. It seems like they are waiting for retirement,” complains the entrepreneur, who claims to be from the “new world” although a native of the old. “Customers want experience and dynamism, it’s a hellish equation.” Laurent also tested cryolipolysis, cold to lose love handles, and peeling, a skin treatment that peels off dead skin at the cost of temporary irritation. “I was red as if I had been boxed in the Old Port,” quips the manager. Total cost: 10,000 euros.
Of Persian origin, Jean comes to “Westernize” his half-moon nose. This team leader in the construction industry based in Marseille, with a pointed beard and precise gradation, has it filled with hyaluronic acid, this viscous liquid that young women use to plump up their lips. Before, Jean found that beauty was mainly a women’s affair: “Among guys, fashion was more scars than moisturizers, but in our time, appearance is becoming more and more important, especially when you have responsabilities.” At first, his companion didn’t notice anything. Then she also started using the syringe.
A few bites lunch time
When you stop, the skin regains its folds. And products exist to eliminate hyaluronic acid. Counterpoint: you have to talk, at least once a year. Each injection costs several hundred euros, “almost the price of a high-end hairdresser”, puts Laurent into perspective. Except for accidents, bites only leave discreet little bruises. “It’s less scary than surgery! My clients request an appointment at the lunch time or on Friday evening, to look rested from the weekend. I am part of the beauty kit, with the hairdresser and the fashion designer”, says Christophe Desouches, the “retoucher artist” of Laurent and Jean. Marseillais, long hair, easy to speak. Complete over twelve months.
The Clinique des Champs Elysées group, 25% of the market, a leading brand with Lazeo, also demonstrates the masculinization of its clientele: “Since Covid-19, videoconferencing has become widespread. Many seniors did not have the “used to see each other so much, which led to a general movement towards aesthetics, from makeup to our care, and opened the field to men,” explains the company’s general manager, Tracy Cohen Sayag. At the beginning of November, she celebrated the opening of a new center in Levallois-Perret, in Hauts-de-Seine. The fifteenth in just over a year. Inside: a room for each medical procedure, each with gilding and portraits of models on the walls.
“A change of scenery”, quite an art
Often, customers want a “change of scenery”. Against the sad look, we raise their foreheads. To put an end to the upset look, untie the muscles located between the eyebrows. Making the jawline more square masculinizes, and thus comes the dominant look. No question of looking like a woman: men leave lips and cheekbones to these ladies. And want, even more than them, for it to be natural. Not to be associated with the outrageous physiques, the whims of a few deranged popstars, or the failures of these injectors who recruit on social networks and improvise as doctors in exchange for a few tickets.
But beautification is not an exact science. It’s not even a specialty: surgeons and dermatologists do have some courses in aesthetic medicine, but they are limited to learning facial anatomy and the presentation of products. Few independent studies rationalize the modifications to be made to “aesthetize”. There are Greek canons, those proportions that ancient sculptors used, general principles – symmetry is better – and a few scientific articles documenting trends. “But, for the rest, it depends on requests,” explains Dr. Desouches.
He defends a minimalist “aesthetic art”, judged. Others, like Dr. Mauricio de Maio, claim to have found the ideal recipe, the secret to beauty on command. The Brazilian surgeon, partner of the manufacturer Allergan, invented the “MD Codes“. Predefined and standardized injection points – up to 75 – that he presents during world tours. Major players in the sector, such as the Clinique des Champs Elysées, share the star’s recommendations. Still, none scientific protocol does not attest to the superiority of one method or another.
None of the substances used have been subjected to clinical trials for aesthetic use. The only drug in the arsenal, botulinum toxin was only put on the market for its effects against the pathologies of muscle stiffness, never for use against wrinkles. A regulatory anomaly, hyaluronic acid is considered a medical device, in the same way as a prosthesis. A category less regulated than medicine. “As we are leaving the drug circuit, there is, for example, no obligation to report adverse effects,” regrets Brigitte Dréno, dermatologist, member of the Academy of Medicine. When it comes to beauty, vagueness prevails.
The great legal and scientific vagueness
To rationalize this medicine which only exists in fact and which does not respond to any pathology, the Academy of Medicine published recommendations in October 2022. It “suggests” a “mandatory” collection of serious adverse effects, followed by actions. And asks that the “quality of clinical studies meet the rules of good practice in clinical research without any conflict of interest”. These experts are also concerned about the lack of compulsory training for general practitioners, more and more of whom inject, sometimes without experience or knowledge.
Many training courses have emerged, but they too are not supervised. “Some are of questionable quality, others, dispensed directly by the laboratories which sell products for aesthetic use, which is unacceptable,” condemns Jean-François Delahaye, member of the National Council of the Order of Physicians. More and more accidents occur after injections carried out by doctors themselves – eyes blocked after injections given too close to the eye sockets, buoys instead of lips… To remedy this, the Order is now working together with universities to offer diploma training, achievable during a career, and to recognize the expertise acquired de facto by certain practitioners.
In the office of Dr Desouches, in Marseille, Laurent does not see himself arrested. And when his neck falls, he will ask for a facelift, a surgical procedure. He even gave one to his 80-year-old mother – “Now, it’s the guys who initiate the girls,” smiles the surgeon. All obsessed with appearance? “I don’t examine my wrinkles or other men who inject,” assures his patient. The other apollons present in the waiting room are keeping watch. They were not sculpted by the practitioner. These are statues, for decoration. No wrinkles in three centuries.
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