Meet The D.C. Derm Politicians Trust With Their Faces

The following is an interview with Dr. Terrence Keaney, MD, FAAD, a board-certified, "gender-specific" cosmetic dermatologist who specializes in treating men in the Washington, D.C. area. This interview has been edited for length and clarity. As told to Lexy Lebsack.

Marketing To Males
About 60 to 70% of my cosmetic patients are men, and a decent amount are politicians — a 50/50 split between Democrats and Republicans. Treatment is different for men based on their anatomy and cosmetic concerns, but there is also a different marketing and communication strategy. We have a loft space with dark wood floors and exposed ceilings, so when a male walks in, he feels more at ease. My last practice was all white, glossy, and ritzy, and a lot of men would question whether it was the right space for them. When guys walk into this office, they feel like their needs will be addressed.

When I started focusing on men five years ago, people thought I was crazy because 90% of aesthetic procedures were done on women, but that paradigm is starting to shift. Now, we see 12-13% of procedures are done on men, which doesn't sound like a big jump from 10%, but it's pretty substantial. Men care about their appearance — just look at luxury fashion or skin-care sales — but have been largely ignored in the dermatology field, so they think that treatments aren't for them.

Gateway Treatment
When a guy comes in for a cosmetic consult, we'll talk about hair loss, his jawline, his wrinkles, and discoloration on the face. I find that the cosmetic gateway for men is a often a laser treatment because we can just shine the light and clean up their skin. This is especially true for politicians who are on TV because they see all the brown spots and broken capillaries. I clean the canvas and then they trust me as a doctor, so then we can move on to other aesthetic treatments. Guys love lasers.

What Men Want
Men think about aging differently and have different concerns. There are three major areas they tend to focus on when they look in the mirror. Hair loss and hair thinning is, by far, the biggest concern. It's the number one thing that ages a man. Number two is changes around the eyes, which men often describe as 'looking tired.' Politicians don't come in saying they have wrinkles or bags around their eyes, they say, 'I look tired and angry on TV.' The last one is the jawline. The cheeks, mid-face, and nasolabial folds are big treatment areas for women, but they don't bother men as much. For them, it's more about the jawline, which is a feature of masculinity.

We often think about male and female anatomy as just breasts and genitals, but the shape of a male face is very different from a female face. Men tend to have wider jaws and flatter cheeks, thinner lips, and flatter eyebrows. When you're using Botox, you don't want to give a guy a peaked eyebrow — some men want that, of course — but in general, you want to maintain a flat eyebrow. When using filler, you don't want to give men full lips or big cheeks, you want to maintain an angular result.

The two main ways I get rid of a double chin are with Kybella, which dissolves the fat, and CoolSculpting, which freezes the fat cells. A lot of men develop a double chin that obscures the jawline as they get older, so their cheeks sort of blend into their neck. There's no line of distinction, it's just a big blob when you lie down. To restore that masculine jawline, you first have to uncover it by removing the fat. Then we'll define with filler along the jawline and chin.

I won't say names, but the concern is to not look political figures who have had a fair amount of work done.
Terrence Keaney M.D.

Discretion Is Key
The approach is very different between the genders, both in what bothers men versus women, and how to treat those issues. Politicians don't come into the office saying that they want to look like a certain person, instead they tend to call out who they don't want to look like. I won't say names, but the concern is to not look political figures who have had a fair amount of work done.

Ten years ago, women didn't talk about Botox or laser peels, but now it's no longer taboo. I always joke that men are 10 years behind women. We're at the stage of the aesthetic market where it's still uncommon for men to talk about aesthetic procedures, but I think that's changing. If you look ahead 10 years from now, the male market will be similar to how the female market is now.

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