Editor’s Note
**Editor’s Note:** This article explores the evolving landscape of male aesthetic medicine, focusing on the use of Hyaluronic Acid fillers. It highlights the importance of achieving natural, undetectable results, cautioning against the overfilled look that has become common.
Male Aesthetic Medicine: Keys to Making It Undetectable
At the beginning of the century, Hyaluronic Acid (HA) began to be used as a dermal filler to restore lost volume in the face. It quickly became the king of aesthetic dermatology, replacing collagen and silicone due to its good bioavailability, as the body recognizes it as its own. It fills wrinkles, enhances cheekbones, redefines the facial oval, and disappears without a trace. So many benefits turned around, and we began to see swollen faces, overfilled faces, and an aesthetic footprint that wasn’t always favorable. Why did the god of youth become a demonic factory of ‘pillow faces’? This is what the experts tell us.
“It is important to differentiate the product from the use made of it. HA remains one of the safest materials in aesthetic medicine. It is biocompatible, integrates very well into tissues, and when well indicated, allows for very natural results. The problem is excess product, repeating treatments without prior assessment, poor indication, or performing infiltrations without a deep knowledge of facial anatomy,” explains Adriana Rodríguez Valera, medical advocate at Evolus, at Clínica Lotus.
Everything Done Now to Prevent Hyaluronic Acid from Causing ‘Pillow Face’
Aesthetic medicine has evolved tremendously in recent years, and it’s no longer about erasing every wrinkle.
“Today we have better products, we know much better the behavior of hyaluronic acid in tissues. Ten or fifteen years ago, it was common to try to correct every wrinkle by adding volume. Today we know that aging is much more complex and that not everything is solved by filling. Often it is more appropriate to combine small amounts of hyaluronic acid with neuromodulators, collagen inducers, or technologies that improve skin quality,” adds the expert, Mar Gonzálvez, Faculty at Teoxane.
And it’s not all about filling the skin as was done before,
“without asking if that area needed support or flexibility, if that plane could accommodate those gels, or if the manufacturing quality allowed the muscles to move naturally underneath,” comments the medical advocate of Evolus. “Knowledge of anatomy, the plane, prior diagnosis, aesthetic taste. If just one fails, the problem appears.”
Quick Guide to Understanding the ‘Pillow Face’ Concept
Avoiding volume excesses in areas like the cheekbones, which could modify expression or alter masculine proportions. Between the ages of 30 and 40, men focus on under-eye circles and a tired-looking face. From age 45 onwards, the most frequent concern is loss of definition in the jaw and chin.
“In general, men seek to look more rested and defined; they ask for that longed-for ‘good face’ rather than rejuvenation. A preventive approach is increasingly common, with small progressive corrections that allow maintaining structure and skin quality without adding visible volumes. The key is a conservative and progressive plan, prioritizing structure over volume and respecting proportions to maintain naturalness.”
Does Hyaluronic Acid Disappear or Not?
“There is some confusion around the idea that hyaluronic acid ‘does not disappear.’ In aesthetic medicine, it is designed to degrade, although it does so more slowly than the one produced by our own body. After implantation, it integrates into tissues and is metabolized progressively. Small amounts can remain longer, which does not mean it still has the same aesthetic effect or that it needs to be removed. Therefore, a negative outcome appears when treatments are performed indiscriminately: excessive volumes, choosing an inappropriate hyaluronic acid for the area. Aesthetic medicine is not a recipe where everyone follows the same steps and timelines.”
“By restoring the different tissues of the face that are lost over time. Of course, poor quality, poor professional, poor technique, poor diagnosis can lead to the opposite effect. If you put yourself in the hands of a doctor – in a medical center – who has been properly trained, uses quality products, and has an aesthetic taste similar to yours, the result improves,” concludes Mar Gonzálvez.
