Do You Even (Brow) Lift, Bro?

Not long ago, if a man was developing etched lines around his eyes, a slackening jawline, or a gradually ballooning paunch, he would meet these changes with silent acceptance. He might not even notice them. After all, to grow older is to grow more distinguished, right? Men didn’t need to fear that showing signs of age might signal they were past their prime, or that they had — heaven forbid — let themselves go. Those things were strictly the domain of women, who have it drilled in practically from birth that they must maintain the illusion of youth at all costs.

But recently, there’s been a shift, and we’re not just talking about “Brotox.” In fact, we may have just lived through a profound boom in male plastic surgery: Between 2019 and 2022, there was a 207% rise in procedures performed on men, according to the American Society of Plastic Surgeons. In 2023, every procedure listed on the organization’s annual gender trends report experienced positive year-over-year growth, with cheek implants and chin augmentation surging almost 20% each. That year, the ASPS even reported that both male chest/core procedures and male face/neck procedures — including facelifts — outpaced female patient growth in those categories.

“We’ve seen a slow but steady increase in both nonsurgical and surgical procedures among men,” says San Francisco plastic surgeon Dr. Usha Rajagopal, M.D. “Younger patients are coming in for facial balancing procedures — such as enhancing a weak chin or addressing a double chin. And for men who are starting to age, the focus tends to be the neck and jawline. They want a stronger, firmer, more youthful appearance.” While the psychological impetus may vary — confidence, or lack thereof, is the most cited driver, while concerns about staying competitive in the C-suite recur on ASPS reports — men are now willing to make interventions in their appearance in ways they never would have considered before.

“The biggest thing that has changed is that men are a lot more apt to talk about these things than they used to be,” says Eric Nietzel-Leone, RN, BSN, founder of the New York–based aesthetics clinic I Wanna Be Pretty (which offers a slate of “I Wanna Be Handsome” services for men, including armpit and scrotum Botox for $1,000 each). “And it’s not just on social media. My practice is like a barbershop. Men are coming in and hanging out in the waiting area or even near the chair where I’m injecting, and they’re like, ‘What are you having done today?’ Breaking down that taboo has been huge. It’s been really helpful for men, because now they see all of this as something normal. No one needs to hide anymore.”

Like a flashy car or a private jet, it’s a flex. It shows that you have the capital to raise your stature in a world where the phrase health is wealth has taken on new meaning.

What sparked the surge? Some of it is the same for everybody: the self-scrutiny of the Zoom era and the sudden awareness of frown lines and other droopings; then the Babel blast of TikTok and its blitz of before-and-afters, in-office bro-downs with plastic surgeons, video recovery diaries — trips to Turkey for hair transplants are a genre unto themselves — and advice both genuinely educational and wildly misinformed. Yet, more crucially for men, the “wellness” movement has reached new heights under a different branding. “The big rise in aesthetic procedures for men is happening right now because of the longevity boom,” says Dr. Paul Jarrod Frank, M.D., a cosmetic dermatologist with offices in Manhattan. “Men have always felt comfortable paying attention to their physicality, working out and taking supplements, and now the health and beauty industries are merging.”

Longevity is everywhere you look. While the over-the-top practices of people with money to burn — like Elon Musk and tech millionaire Bryan Johnson, the latter of whom famously received plasma transfusions from his son and delivers shockwaves to his penis — are breathlessly documented (and ridiculed) by the press, many of the next-level ideas touted by Silicon Valley bros have gone mainstream. You can’t throw a Peloton shoe without hitting a “wellness center” offering ice baths, hyperbaric chambers, and lymph-draining robots. And who isn’t thinking about tracking everything from blood glucose to sleep cycles? Men are already optimizing, maximizing, and quantifying everything from their microbiome diversity to their oxygen uptake to their blood biomarkers; they’re on Reddit posting muscle makeovers on r/brogress and sharing not just macros but testosterone and steroid use. They’ve realized that their looks are yet another place where they can move the needle. Says Frank: “Wrapping their heads around it from a wellness standpoint rather than a vanity standpoint has been a game changer.”

Another factor, he and other doctors theorize, is the craze for GLP-1s, which address the ultimate confluence of wellness and vanity: body weight. (Plus, people who drop weight rapidly can look older or have less-than-taut skin, and that’s not a trade-off that many men are willing to accept.) “Middle-aged men who are getting their mojo back with peptides or GLP meds or testosterone want to look as good as they feel,” Frank says. It’s a look-good/feel-good boost, and it works in a way that it never has before because it’s now understood to be a two-way street.

“Before the major wellness boom, people would come to me wanting procedures done, not realizing that these things can’t do a lot when you need to lose 20 pounds and you drink too much,” he adds. “There is no cosmetic treatment that can fix the things that need to be addressed from the inside. Now they see the interplay between the inside and the outside, and that’s really empowering. I think men really dig that.” If you can, to a certain extent, play God with your lifespan and your libido, why not with your appearance, too?

“My practice is like a barbershop. Men are hanging out in the waiting area or even near the chair where I’m injecting. They’re like, ‘What are you having done today?’”

For some patients, this thinking has led to some extreme makeovers. Leg-lengthening surgery, for example, is having a moment — despite its notoriously long recovery period, which prevents patients from walking unassisted for up to six months to achieve results. Dr. Michael J. Assayag, M.D., an orthopedic surgeon at the International Center for Limb Lengthening, in Philadelphia, says that he fields at least five inquiries about the procedure a day — some from men who are already 6 feet tall. Dr. Kevin Debiparshad, M.D., a Harvard-trained surgeon in Las Vegas and a go-to for tech billionaires, software engineers, actors, and basketball players, performs leg lengthening and says that his website gets 30,000 unique views a month — a number that surged in the wake of the film The Materialists, which features the surgery as a plot point. For his patients, he says, undergoing the procedure “is power.” Like a flashy car or a private jet, it’s a flex. It shows that you have the capital to raise your stature — literally — in a world where the phrase health is wealth has taken on new meaning.

Speaking of which, legs aren’t the only body part men are extending. New York plastic surgeon Dr. David Shafer, M.D., FACS, was among the first to offer penis enlargement using hyaluronic acid dermal filler (the same that’s used to lift and volumize the face). Since he introduced his procedure, which he calls S.W.A.G. (Shafer Width and Girth), in 2017, he has performed more than 8,000 treatments. “The idea initially came from a patient’s boyfriend, who was tagging along for his girlfriend’s lip-filler appointment and half-jokingly asked me if we could inject filler into his penis,” Shafer says. “He actually came back the next day for a couple of syringes. Within a few days, he called me and said he loved it but wanted more.”

If you can, to a certain extent, play God with your lifespan and your libido, why not with your appearance, too?

Shafer compares it to breast implants for women, though it’s fair to say that men are less likely to choose subtlety. “Some patients are curious about what it would feel like to have a more prominent enhancement, while others are influenced by past partner experiences or societal perceptions of size. Some enjoy the glances toward their crotch when walking down the street or the TSA pat-down for ‘something in their pants,’” Shafer says. “But ultimately, the most common concern is wanting to feel better in their own skin and create a more impactful first impression with partners — whether visually or psychologically.”

There’s even a wellness angle to it now: Nietzel-Leone, who also offers penile enhancement injections, often combines it with PRP (platelet-rich plasma) therapy. “It can help stimulate better blood flow to the area, which will give you better erections, and it can build collagen, which means that you have better skin texture and healthier tissue,” he says. “Women are more focused on their faces, but guys are thinking about what these things can be used for elsewhere.”

Still, Frank says most men are fairly conservative when it comes to nips and tucks. “Men like quick fixes,” he says. “They’re afraid of looking too different, so they’re more likely to go for Botox or laser resurfacing, at least as a first step.” And while younger guys will ask for more obvious transformative treatments like stronger jawlines — “They want features they never had” — the average middle-aged man “just wants to look less tired.” He notes, though, that they are now much more open to the prospect of having major surgery when they feel it’s time. “You can thank Brad Pitt and Bradley Cooper for that,” he says. “Those are two men everyone kind of knows had work done, but they both look great, and they still look rugged.” But if social media is any gauge — and when is it not? — it may be only a matter of time before dramatic is the new subtle. Women can tell you: Guys, it’s a slippery slope.