Gaining Trust and Confidence: The Progression of Male Aesthetics

Join us for George’s presentation, “Men Aren’t So Tough: Understanding the Male Aesthetic,” at Modern Beauty Con, on May 6, 2023, at the Boston Park Plaza.

 

If you ever have the chance to speak with George Baxter-Holder, take advantage of it. You’ll quickly realize he invests himself in the conversation, freely sharing both his extensive knowledge and personal experiences with a charming blend of candor, humility, and humor.

 

He offers the same generosity during his patient consults, where he takes the time to determine their goals and concerns so he can develop a plan that ensures their well-being both physically and emotionally. 

 

As a preview to his Modern Beauty Con presentation “Men Aren’t So Tough: Understanding the Male Aesthetic,” we explored men’s biggest motives for, and fears about, aesthetic treatments. But in the course of the conversation, George also offered many insights about his approach to the ethics and artistry of the profession, which is sound advice for providers working with any patient.

 

You’ve often talked about how aesthetic treatments are as much psychological as they are a matter of physical attributes or vanity. Have you found that male clients are less willing to be vulnerable or “go there” when it comes to the psychological aspect?   

GBH: I think there’s some similarities in the way men and women show up in clinic, but there are contextual differences. There’s an ideal beauty that women are faced with—through social media and the media in general—so they may be focused a little bit more on that ideal. With men, I think it’s not so much perfection-based, but as we age, there are certain aspects and attributes of the male aesthetic that soften—particularly the chin and the jawline.  

 

To answer the question, the psychology is very similar, but I wouldn’t say that the vulnerability is. I think that men tend to be less vulnerable in my chair than women are.

 

Does that mean building a relationship with a male client requires a different approach? 

GBH: It’s definitely different. In general, establishing a relationship tends to be easier with a woman, because, as touched on earlier, there’s so many more preconceived notions about aesthetics. But in order to create a relationship—whether it’s a male client or a female client—they have to trust you. They have to understand that you know where they’re coming from. For male clients, they need to know that you’re not going to feminize them, which is my big push—for providers to understand the male/masculine aesthetic so that the trend is not a feminization of men.

 

Is that one of the most significant fears that male patients have?

GBH: There’s some significant fears male patients have, based on preconceived notions about what’s gonna happen in the chair. The unspoken fear is pain. Believe it or not, I think men handle pain much worse than women do. That’s kind of a common note among injectors—that male pain needs to be treated much more profoundly than female pain. 

 

What steps do you take to manage that, both from a physical standpoint and an ego standpoint?

GBH: From a physical standpoint, I just make sure that all of my patients know that I take pain very seriously. I make sure to acknowledge they may have fears about pain. And if they’ve never had treatments before, I acknowledge how the anxiety of the unknown also creates pain. Just saying that out loud helps people.

 

From an ego standpoint…part of the way I create relationships is, I really don’t let them go into that ego place. When the doors close, I try to allow them the space to let that go, and know that they don’t have to be tough—and that I’m not tough in the chair. I share my own personal experiences with them.

 

So that’s something you address very directly right away?

GBH: Yes, it’s something I address in the consult. I want to find out what their fears are. And when I dig down, the two biggest fears—for both men and women—are pain and looking unnatural. 

 

Would you say that every practitioner develops an aesthetic fingerprint/style as far as their treatment goes?

GBH: Definitely. And I think that fingerprint changes over time. I know mine has. Sometimes they’re just really subtle differences, but because every injector is an artist, every artist has a style. 

 

I would think that for younger injectors the concept of a defining style could be intimidating. Do you have any advice for just accepting your style or how you can be inspired by others but not lose your style?

GBH: Absolutely. The advice is as sound as it was when I got it from Steve Yoelin. I was doing one-on-one training with many of the world’s great injectors. I spent quality time with Dr. Danny Vleggaar and Rebecca Fitzgerald and Shino Bay and Steve Yoelin. Steve was one of the last ones I spent time with, and he said, “George, you’ve studied with some of the greats in aesthetics, and now I want you to stop. I want you to stop, and I want you to go perform your art. I want you to synthesize everything you’ve learned and establish your style.” And that was the greatest advice that anyone could ever give me. Because what he did is, he gave me permission to go and just do—and stop trying to imitate.

 

What would you say is the timeline between when you’re imitating/learning and when you can give yourself permission to “just do”? 

GBH: A good five years of quality full-time injection. You can’t dabble and expect to learn it. It’s like any other craft, you have to spend 10,000 hours to become an expert. 

 

To return for a moment to client fears, how does this concept of a practitioner’s style reconcile with the fear of looking like you’ve had work done? 

GBH: The biggest thing is for the injector to create a plan that’s in line with the client’s goals and that takes them to where they want to be, in a conservative fashion. When I set a plan, it’s not one-and-done. It has a progression to it. I might make a jawline out a little slower than their cheeks, for instance. But it has a global perspective of the whole face versus each specific aesthetic unit. 

 

I think we’ve come a long way. We used to focus on aesthetic units—like the nasolabial fold or the temples or the brow. Now we don’t focus on anything in isolation. It really has to be done in a global sense.

 

Do you find that once you go through the consult and develop a plan, most patients are committed to it, or do some just drift away? How common is it for a client relationship to last a significant period? 

GBH: It’s part of the consult. You have to start right at the beginning and make sure that people understand that what they’re asking you to do is not inexpensive. That’s the first piece. Clients can get a little shocked by the price tag. And that’s because the media hasn’t done a great job letting people know what the price tag could be. People come in—I can’t tell you the number of times people come in—and they’re like, “Oh, I have $1,000 to spend.” 

 

One thousand dollars is a maintenance plan. In order to get to the place where you’re able to spend $1,000, you really need to spend $5,000 to $7,000. Allergan has done such a phenomenal job bringing Botox to the dining-room table. And because of that, people think it’s like getting your brows tattooed or something. A simple Botox treatment is $1,500 a year. I don’t know the percentage of people who have $1,500 a year to spend on something like that. But it’s not an inexpensive proposition. When they want to address their lips, it’s another $1,500. Cheeks and jaw—the price tag goes up quickly. It’s quite easy to spend $10,000 on your face.

 

What are the areas you find men are most focused on?

GBH: The jawline and under the chin. There’s a little fat pad under the chin that softens the whole male aesthetic. They’ve done plenty of studies about the jawline and how a strong jaw elicits trust and strength and all these other traditionally masculine adjectives. So when there’s a little fat pad that rounds it off, or you get heavy around the jowls and the jaw bone doesn’t have any prominence to it, all of a sudden the exact opposite of those adjectives becomes true. So whatever role in society they play—whether they’re a lawyer or a doctor or an auto mechanic—that sense of them ebbs.

 

Those are all professional roles. Would you say that a big motive is status in the office as opposed to status in, say, a bar or something like that?

GBH: It’s probably equal. I don’t know for sure because I haven’t seen the data on that particular question. But I think one leads to the other. If you’re successful in the office, it helps you in the bar, right?

 

So that confidence is contagious? 

GBH: Exactly. If you’re successful in your office space because you look confident, it in turn increases your ability to act with confidence. That’s that piece you started this interview with—the psychological piece that I talked about before: When you look the way you feel, it leads to a more confident presentation in the world.

 

Would you ultimately say that confidence is the subtext of a consult and treatment plan?

GBH: Yeah, that’s the subtext of the plan. I want to know where I’m meeting them. So it starts off with: “What brings you in to see me today?” “Why?” And, “Why now?” Those are my three questions. It’s like, “So what brings you to see me today?” “Oh, I feel like I have a really weak jaw.” “OK, so why do you want to do something about that?” “Well, I feel like I’m not looking as young as I used to, and I’m up for this promotion…” Or, “My daughter’s getting married, and I…” The “Why now?” is the most amazing question because what you find is that people have this urgency for coming in today versus someday in the future.

 

If there’s a deadline, does that have an effect on the long-term relationship?

GBH: One hundred percent. If they haven’t given you much time, then you have to establish that trust faster. But that all happens with a really transparent conversation. “Look, it’s July, and your daughter is getting married in October. You haven’t given me a long time to take care of these things, so let’s backtrack.” There’s certain things, like Sculptra and lasers and skin tightening, that take time. Filler is immediate, so that’s something you can get an immediate viewpoint on, but really doing a global aesthetic consult and assessment…you need time. I wish more people understood that. Give me a year to get you where you want to be, not two months. 

 

Do you find that somebody who gets treatments for, say, a wedding will keep going afterwards? 

I think so. I will say that more women get work done for weddings than men do. But I’ve seen a trend with 20th high-school reunions. I have a lot of men that come in before their 20th high-school reunion. When you think about it, they’re almost 40…

 

Is there a correlation between whether they’re still single? 

GBH: Yes. Absolutely. If they’re happily married, then generally the only time I will see them in my chair is if I see their wife in my chair, and they’re just trying out Botox because their wife tries out Botox. Or it’s, “My wife wants me to get treatments for my hair.” 

 

When we spoke with [AmSpa founder] Alex Thiersch, he told us that one of the growing entry points for male customers is hair treatment. Would you agree that’s becoming a gateway for new clients?

GBH: [Laughs] Having had three hair transplants myself, yes, I would absolutely agree with that. 

 

Does that affect the general age of clients? Do you tend to focus on a particular age of client? 

GBH: I don’t focus on a particular client. My male clients tend to be a little bit older than my female clients. Like I was saying, that 38-year-old who’s coming up on the 20th high-school reunion. They’re single or newly divorced. Depending on where they are in their career, it can be a trying time.

 

You’ve spoken in the past about times you’ve decided not to treat a patient, which speaks to the artistry and integrity of your practice. But I do get a lot of emails from younger practitioners who might not feel like they are at liberty to turn clients away. What kind of advice would you give people who feel like they don’t have the same freedom in terms of client selection?

GBH: That’s key. I’m not going to speak about gender differences for this particular part of the conversation because I don’t have enough data. But to answer your question about newer injectors who feel like they can’t say no or they have to move forward with treatment…my question to that is, Why do they feel that way? Is it a financial thing? Is it because you’re trying to please everyone? Because the sooner you can get past that impulse to please or that impulse that you can’t say no, whatever that thing is, the better you’re gonna be as an injector and an artist.

 

Because you can say no. And if you listen inside when that comes up, you’ll know that you shouldn’t have treated. I’m only saying that out of personal experience, because every time I’ve treated someone that I’ve had a really negative experience with in the long run, I knew I shouldn’t have treated them in the short term. My initial feeling was right. So if you are thoughtful and slow and methodical in your consult, you will have a much happier career as an injector. You won’t have to make some of the huge mistakes that myself and others have made over the years, where we felt like, “Oh no, I can be everything for everybody.”

 

Try not to focus on the money coming into the cash register—because that’s the problem area. When you’re focused on that, you’re gonna make mistakes. 

 

There’s safety issues with that as well. I see so many young injectors doing liquid rhinoplasty, and these same injectors have never been to a cadaver lab, have never studied anatomy, have no idea of the vasculature. There are all sorts of issues that can go wrong.

 

You really don’t know what you don’t know. Some newer injectors will say, “Oh, that’s OK, I use BD needles.” Or, “Oh, that’s OK, I only go in the center of the nose.” I hear all of this stuff, and it’s never OK. There’s no device that’s safe, there’s no place that’s safe. 

 

When someone is really well trained, they’re going to be a better, more proficient, more expert injector and the industry is gonna thrive. The converse to that is also true. There is a certified aesthetic nurse specialist, and that is the only certification that is recognized nationally. Everything else is marketing hype by some of these fly-by-night certification bodies, which set people up to think they are more proficient than they really are.

 

Lori Robertson shared a similar stance when we spoke with her. 

GBH: She and I see eye to eye on that piece. Absolutely.

 

The topic of male clients has earned some buzz in the news. Was your impulse to give this presentation because you’re getting more questions about the topic or was there some other inspiration?  

GBH: It’s probably multifactorial. I’m still in the minority, both as a client and as an injector. So I’m highlighting that. It’s funny because I was the graduation speaker when I received my master’s at the University of Washington and when I graduated with my doctorate at Duke University. At both graduations, I talked about being a man in nursing. So “Men in the minority”  is a topic I’m personally very interested in. That’s one side of it.

 

On the other side, we had a market penetration for men of about 6 percent for many, many years. And I just read a study in AmSpa that it’s gone up to 12 percent. So since I’ve been in the industry, it has doubled. Six to twelve is still not very high, but it still has doubled. And we’re also aligning treatments for men. The new jawline product that came out from Allergan, Volux, is beautifully suited for men. It’s all right for women, but it’s exceptional for men. And so that leads the conversation a little bit more towards, “What can we do for men and the male aesthetic?” 

 

In general, we’re offering more treatments that men would be more interested in than, say, cheek filler. So when everybody’s doing cheek filler, men are not going to be that interested, but as treatments are aligned with the male aesthetic, the male aesthetic population will grow. And I think that’s what we’re seeing. It’s not just hype, and I don’t think it’s just a flash in the pan. The more light we shed on it, the more growth in market share we’ll see. Will it ever be 50-50? I don’t think it will be, but I think we still have room to grow the market share.

 

Join us for George’s presentation, “Men Aren’t So Tough: Understanding the Male Aesthetic,” at Modern Beauty Con, on May 6, 2023, at the Boston Park Plaza.