AESTHETICS FOR BROS

Co-founder of the Sisu Clinic Dr Brian Cotter looks at the rise of male aesthetic treatments

Sisu Clinic was founded in 2018 by brothers Dr Brian and Dr James Cotter and Irish tech entrepreneur Pat Phelan with a focus on doctor-led aesthetic treatments that are noninvasive, effective, and safe.

Dr Brian Cotter started his career in trauma and orthopaedics, but always had an interest in aesthetics. He considers how perceived male beauty standards have changed over the last decade.

THE MALE AESTHETIC

Often male patients don’t want to drastically change their appearance, instead focusing on a small correction to an area of concern, such as the under eye or skin texture.

“When you have a consultation and listen to a male patient, often the thing that they want to change is something that flies under the female radar; they want to get something bespoke to them. Men are more muscular in the face and the muscles tend to be a little bit stronger, particularly in areas like the glabellar.”

Often men in their 50s and 60s seek treatment before a pivotal life event.

“The biggest factor with male patients is probably when their daughters are getting married and they’re going to walk them down the aisle. For them, it’s more about looking their best, looking fresher. I’m in my mid-30s; a lot of my friends who, 10 years ago, would have raised an eyebrow (excuse the pun), are now having treatments like hyaluronic acid and botulinum toxin.

Dr Cotter accepts that men are not as thorough as women when it comes to skincare. “My girlfriend, gets treatments, but she also does the 15-step cleanse on a Wednesday evening,” he comments.

“Women are probably a little bit more ritualistic, whereas for guys, even using SPF now is a pretty big thing. Men are probably more geared towards skin health and quality, rather than removing folds in the face; treatments like hyaluronic acid are usually popular amongst male patients, because it doesn’t radically change their aesthetic.”

But why is the stigma around treatments, particularly for men, breaking down? “I think the perception has radically changed – people are far more open. Now, there’s an understanding with most reasonable people, that if you want to do something, and it doesn’t cause any harm to yourself or others, then do what makes you happy. I think a lot of people will have treatments done quietly, but if you ask even a group of my friends who’ve had treatments, it’s gone from a laugh and a joke to ‘Tell me a little bit more about it, I’m interested’.

“Male patients are now more comfortable with saying ‘Actually, I went to Sisu and I got botulinum toxin injections’. Men are generally a little bit behind females in most kinds of rational thought processes and I think we are probably picking up the slack a little bit later.”

He compares the male injectables space to male skincare in the noughties. “When I was in the gym, if a guy was putting on moisturiser, he’d almost be hiding in his locker – it’d be a quick dab. Now, you walk into a gym, and there are male under-eye creams, hyaluronic acids targeted at men, SPFs for men, etc. I think the trend that a lot of guys will move into will be the skin booster side of things. It’s funny – if you say ‘Botox®’ to a guy, probably in a very deep-seated part of their brain, they think ‘Oh my God, I’m going to look weird, like a Ken doll’. However, if you say, ‘We have this treatment, it’s a high-grade hyaluronic acid, or an injectable poly-L-lactic acid in a treatment like Sculptra® – it’s going to make your skin look better, you’re not going to look weird, it’s about the quality, texture, moisture content,’ I think that’s a space men will move into with relative ease.

Often, however, guys are dragged in. They show up to the clinic and say, ‘My wife said I’m to come in and talk to you about my under eye’!

GLOBAL TRENDS

Four years after being founded in Ireland, Sisu had opened 21 clinics worldwide, from Mayfair and London, to Manhattan, Miami, Fort Lauderdale, and Coral Gables. The business is currently planning to open further clinics in London, Florida, New York, and Texas.

I think what’s interesting, particularly between Ireland, the UK and the US, is the behaviour of patients as human beings”, he comments. “I’m not going to get philosophical, but looking at their wants, fears, and aspirations around aesthetics, probably the biggest difference is that UK and Irish clients are primed towards an area model for botulinum toxin. The US uses dollars per unit which can be confusing and leads to a patient being over prescribed. The value of the sale is often more important than that outcome in the US and patients can often have a ‘sticker shock’ price moment in the consultation. The market is less transparent for the patient in the US when compared to Europe.”

He says American patients normally start getting treatments earlier, but he has also noticed variations between patients in different states.

“I think within the US generally, they are a bit more aware of the preventative side of things – it’s a very different subset of patients. In Miami, they’re very into their fitness and looks – there’s probably cultural difference within it: about 70% of the population within Miami are Latino.

“Within Florida, there is probably a more aggressive consumer and, unfortunately, the market is primed to facilitate that, as opposed to educating the person. In New York, patients are probably more conservative, more aligned with a European aesthetic. Even within the US, there are differences in terms of how the patient behaves.”

Probably the biggest difference Dr Cotter observes is that generally, Americans are prepared to spend money for quality service and an excellent outcome. “With Americans, we don’t hear ‘I can get it done cheaper’ – they’ve made the decision, they’re having it done and what they want is quality, safety, efficacy. Within the UK and, to a certain degree, in Ireland, you hear ‘Oh I can get the filler for £120 from Mary, who comes to my kitchen’. An American will stop dead in the street and run a mile if you say that to them. There’s this idea of the price of everything and the value of nothing; I think within the US, that’s just not there because, culturally, they behave a little bit different around the medical space.”

Dr Cotter thinks UK consumers are less aware of the value of a qualified professional because they aren’t as used to paying for medical treatment.

“Reviews are very important because they give the patient an insight into what happens in the clinic. Also, we’re a multi-country group, so patients think ‘If you’re doing this in three different countries on two different continents, you have to be pretty good at what you’re doing’. The biggest factor is that they understand and know who the injector is. What often drives a patient’s decision to come into the clinic is validation from other human beings that they have had a positive experience. They come into a clinic, then their mum comes in, and then their husband. For us, reviews are the most powerful piece of marketing – it’s all about what we call ‘empathic medicine’. When somebody sits down and reads a review, they will intrinsically see themself in that person – they’ll think ‘That’s me’.”

MALE BRANDING

So, how can you attract more male patients to your business?

“This term, ‘Brotox’ is funny. If you put ‘turbo’ or something before a word, it looks a little bit more presentable to a man. The big thing, if you look at our clinic design within the US, and even the new London clinics were opening, it’s very modern and minimalist. I think the biggest factor for most people is the information base and how comfortable they feel within that space. We have male patients, but female patients are the major percentage of the treatments that we’re doing.

“How you communicate to a man and to a woman in terms of selling is different, but how you communicate to a male or a female in terms of education is the same. When you look at hard marketing, the ultra-pinks and the soft yellows are probably geared towards female patients, but I think the wording in the communication is universal.

“A big element around these treatments is fear; people are afraid of how they’re going to look should something going wrong. If you meet fear with information, it leads to understanding, and understanding leads to empowerment. That’s where we step in. We’ll never tell somebody, ‘You need this, this, and this’, but we’ll go through a very detailed consultation, where the patient understands enough about it to be comfortable and not feel overwhelmed. Trust is both earned and given.”