People all over the UK undergo non-surgical treatments like fillers every year, but the industry operates almost completely unchecked. Fill Me In is a VICE UK editorial series in collaboration with Save Face, the national register of accredited aesthetic professionals, that aims to raise awareness of the dangers of unregulated procedures. Read all the stories from the series here.
You slide into a reclining chair. Your face is cleansed, photos are taken, your skin is marked with pen. A syringe filled with dermal filler slides into your jaw as your chosen practitioner begins to sculpt, define and contour a new shape for your jawline.
This is a new beauty regime reality for an increasing number of both straight and queer men. It's called a masculinisation package, and it can include everything from this kind of jawline augmentation to cheek and chin fillers. In some London clinics it'll set you back around £2,500 – not that the price tag is putting people off.
"The rise in the interest from men for this kind of treatment has grown exponentially," says Dr Melanie Castelhano, who runs a private practice in west London and does this work alongside cosmetic dentistry. "In the last two years there's been a real lean towards masculinisation. It's easier to access, readily available and people are becoming more knowledgeable about it."
The male beauty ideal has shifted in the social media age. Where a photo of David Beckham in a sarong was once front page-worthy, and applying moisturiser considered radical, now the ubiquity of reality TV shows such as Love Island – along with gym selfies and the desire to document everything from wellness crazes to #legday – has made modern-day male beauty ideals hyper-visible.
Mark McCormack, a sociology professor at the University of Roehampton, sees this as part of an evolution going back decades. "You had the metrosexual in the 1990s, and that was at the vanguard of softening masculinity," he says. "The 20th century version of softening masculinity was metrosexuality, and the 21st century version is this kind of Love Island image."
Such is the demand for this kind of work, and the impact of Love Island, that the British Association of Aesthetic Plastic Surgeons (BAAPS) name-checked the show in its annual 2019 report on the increase in male liposuction. Overall, male cosmetic surgery figures – such as facelifts – actually dropped by 4.7 percent because of the increased attraction to non-surgical treatment such as masculinisation packages. "Non-surgical treatments gained popularity driven by the trend for men preferring to look tweaked rather than tucked," said the report.
But not everyone is trying to replicate what they see on TV. For some, it's age management. Paul*, one of Castelhano's clients, is 51 and has been getting regular cheek filler for some time. "There was a sense of not being happy with the way my face was," he says. "I got filler in my cheeks to support the face structure. You get to my age and you lose fat from your face. This can result in a hollowed-out look."
Matthew Manton, a 43-year-old Australian, is both patient and practitioner. As a qualified cosmetic nurse based in Brisbane and South Queensland, he administers these treatments and has personally travelled to London to have a "crapload of filler" to alter the shape and definition of his jawline. He says that the popularity of masculinisation procedures has increased "astronomically".
But what's changed? Why are more men gravitating towards having work done? "I think of this in the realm of a gym membership these days," says Manton. "People go there and keep their body in shape, and this is just another avenue we have at our disposal now." While gay men make up the majority of Manton's patient list, he says this is changing as more heterosexual men are introduced to the procedures by their partners. They start off with Botox, he says, and then realise what else can be done.
Why did Manton feel the need to change the shape of his own face? "Nobody trusts a skinny cook," he says. "Personally, I like to see a strong defined jawline on my own face and a sharper cheekbone, because that's what I perceive as a more masculine or attractive appearance. That is also what many of my patients are seeking."
Castelhano says it's not uncommon for men to come in with similar thinking. "They do usually come with an idea of what constitutes a masculine look," she says. "It's usually a more chiselled look – they might say something like, 'Can you give me a jawline like Brad Pitt?'"
Pitt represents the kind of man Castelhano and Manton’s patients want to emulate. The beauty ideals for men – a chiselled jawline, strong cheekbones – have remained largely the same over the years. After all, there’s not a lot separating the Ad Astra star, looks-wise, from Cary Grant or James Dean.
This look is, of course, highly gendered and is, in turn, linked to being perceived as more attractive. Unsurprisingly, a recent Cut article found incels pursuing extreme facial surgery in order to transform themselves into "Chads" – the hyper-attractive alpha men they alternately worship and hate. "It's about more than looking manly," Manton says of masculinisation fillers. "It is a desire to be attractive."
What’s new is the increasing accessibility of cosmetic procedures that promise to bestow Hollywood looks onto regular guys. As Manton puts it: "We aren't creating a new aesthetic goal. The goal hasn't actually changed – it's always just to look better – but now we just live in a world where the goal is more attainable."
Dermal fillers represent the tipping point of this new accessibility, thanks to the fact that the industry is currently unregulated. In other words, you don’t have to be a doctor to offer fillers. In fact, you don't need to have any training at all – while Botox requires a prescription, anyone can buy fillers online and set themselves up as an aesthetician.
"It's cause for concern," says Castelhano. "Regulations have to come into play. At the moment, aestheticians can administer it, but that should absolutely not be the case." BAAPS expressed serious concern about this in its 2019 report, stating: "The non-surgical sector is rife with lax regulation and unethical promotions."
Save Face is a national register of accredited non-surgical cosmetic practitioners, and campaigns to stamp out bad practice in the industry. It has seen a troubling rise in botched work for both men and women. "Last year we received 934 reports from patients regarding complications and procedures gone wrong," says its director, Ashton Collins. "Ten percent of which were from men. This has risen exponentially versus the year before, when we received less than five reports from men."
To further drive home the link between Love Island and the very real impact it has on people wanting to alter their appearance, Collins says they have been able to identify peaks in the number of men using their website – as well as reporting complications – during the show's ITV2 broadcast slot.
Someone who's seen this impact up close is one of Castelhano's patients, a 31-year-old influencer called Rob*. "Reality shows have had the biggest impact," he says. "The clinic where I had my first Botox treatment had three people having work done, ready to go on Love Island. That tells you a lot about the pressure to look good in today's society. You see guys that look perfect – veneers, good jawlines, tanned and wrinkle-free. Then people react on social media saying how perfect they look. so of course you'll think, 'I need to look like that.'"
As an influencer, presumably that pressure applies to Rob too? "You definitely feel the need to look your best," he offers, but declines to reveal which procedures he’d had done. "I don't think having a strong jawline defines your masculinity. But guys see celebrities and models all over social media and want to have the perfect jawline like them. I know a guy who recently had his done and now he's modelling for ASOS."
McCormack believes the popularity of these fillers has more to do with the rise of social media than about changing masculine ideals. "Instagram adds to this feeling of needing the right body, facial shape and level of attractiveness – which is really more about digital changes to the way we look at things and people than masculinity, per se," he says. "It's about living Instagram lives and the pressures that come with that."
All of the people, both on the receiving and administering side of things, agree that it’s something we’re going to be seeing a lot more of. Rob says: "I believe that, in the near future, cosmetic work will just be the norm – like going to get your hair cut."
* Name changed at the request of interviewee
If you have been affected by any of the issues raised in this piece, please visit Save Face, email email@example.com or phone their hotline for advice on 01495 239261.