By THÉRÈSE MARGOLIS

What are the features that make a woman feminine and a man masculine?

Certainly, body structure and form – along with genitals – define a person’s sexuality and gender.

But it is our unique facial features, our individual physiognomy, that gives each of us our most important sexual identity with which we confront the outside world.

And while makeup, hair and clothing can do a lot to reinforce the outward definition of our sexual identity, nothing is more telling about who we are than the biological and physical nature of our visages.

So it may seem surprising that most Mexican men and women do not feel that their faces adequately express their personal sexuality and gender.

“About 60 percent of women in Mexico don’t feel that their faces are feminine enough,” aesthetic and reconstruction surgeon and director of the Health and Medic Corporate group Juanjo Duque told Pulse News Mexico in a recent interview.

Even more surprising, Duque — who, after specializing in cosmetic and reconstructive surgery at the University of Venezuela School of Medicine and completing a Master’s Degree in aesthetic and antiaging medicine in Madrid (as well as a degree in advanced cosmetic medicine in Santiago, Chile), has, for the last eight years, been focusing on nonsurgical esthetic medicine that accentuates and reinforces gender identity — said that about 80 percent of Mexican men don’t feel that their faces are sufficiently masculine.

“A lot of women think that if they can make their faces more oval, as opposed to round, or make their noses smaller, they will look more feminine,” he said.

“And a lot of men think that all they need to make their faces more masculine is a strong, squared chin. But the problem is that feminizing or masculinizing a face requires an integral approach. Just changing one feature will not resolve the problem.”

Duque said that, in many cases, doing facial reconstruction of a single feature can actually prove counterproductive.

“I believe in three-dimensional facial sculpting through medicine,” he said.

“To create a natural-looking effect, you have to work with the entire face, and harmonize all the features on it. The chin has to be congruent with the nose, which, in turn, has to integrate with the cheekbones, and so on and so force.”

Duque said that he will not even begin to perform nonsurgical procedures on a patient until he has studied their faces and expressions from every angle, and then he works carefully to create a unified and harmonious effect.

In the case of women, that can mean re-sculpting the nose, cheekbones, chin and forehead to create a softer, less masculine appearance.

For men, the objective is to create more dominant, masculine features, with squarer, more chiseled jawbones and prominent brows and chins.

“The two features I never touch are the eyes and smile, because these are what define a person and what makes them look line who they are,” Duque said.

“The objective of aesthetic sculpting is to leave a person looking like themselves, but improved. You don’t want someone to know you had a brow lift. You just want them to think you look great, a better version of yourself.”

Duque said that, today, most people are looking for nonsurgical ways to improve their appearances.

“They don’t have the time or inclination to go under the knife, so injectables have become the procedures of choice,” he said. “And since there are so many new injectable options available now, it is easy to improve their facial sexual identify without them having to endure surgery.”

And while Duque said that there will always be some aesthetic procedures (such as breast and buttock implants) that will require surgery, a lot of them can now be done through injectables.

In addition to traditional hyaluronic fillers and Botox, Duque said that he also employs organic silicium, which can have more dramatic effects and last much longer than other injectables.

Permanent silicium injectables also allow Duque to conduct nonsurgical nose jobs that can be done in less than an hour with immediate results and no down time, making out-patient rhinoplasty more precise with more natural results than those produced by surgery.

But while last year more than a million medical aesthetic procedures were conducted in Mexico, Duque warned that not every doctor is qualified to administer injectables or practice nonsurgical facial sculpting.

“Yes, first you have to make certain that your physician is a qualified plastic surgeon or dermatologist,” he said.

“But you also need to know if he or she has an artistic sense of human aesthetics. Not everyone has that quality, and facial sculpting is definitely an art. What I see myself as doing is sculpting with medicine, and each face I work on is unique and requires its own approach.”

Duque said that unless a patient is willing to allow him to work on their entire face to create a natural, harmonized appearance, he will not even accept them.

“In nature, human facial features are harmonious, and that is what facial sculpting is meant to accomplish,” he said.

The most difficult patients this “Michelangelo of the Flesh” has dealt with are those who have previously had a facial procedure that was either poorly done or not matched to the rest of their features.

“I can usually correct these issues by at least 70 to 90 percent, but it is a lot harder than dealing with a patient that has not had a previous procedure,” he said.

“I refuse to leave a patient half-finished or with a feature that has been adjusted but that does not match with the rest of their face,” he said.

“If a patient says that they want to do the procedures one at a time, then I simply send them home and tell them to come back when they are ready for an integral facial re-sculpting.”

The only exception Duque will make is in  certain cases of nonsurgical rhinoplasty.

Duque’s all-or-nothing approach to injectable facial molding and gender emphasization does not come cheap.

Depending on the materials used and the expected lifetime of the procedures involved (which can last anywhere between a year and a half to 10 years), the price of a holistic facial feminization or masculinization can run from 40,000 to 180,000 pesos.

Still, the effects can be astonishing, transforming in just a single session (with up to two post-procedural re-touches) a round, flat face with a saggy, un-masculine chin into a manly squared jawline with a prominent ridged brow.

In the case of women, Duque can, through fillers and other injectables, soften a rugged chin, reduce the prominence of a too-large nose and create the look of high, feminine cheekbones, with the appearance of lush, sensuous lips.

“I always talk to the patient before I perform any procedures so that I know what they want to accomplish regarding their facial appearances,” he said.

“Many times, they have a mistaken concept of what will make them look more feminine or more masculine, and I point out to them how a more integral approach can emphasize their features without looking unnatural or incongruent. I always work with them so that they are happy with the final results.“

More information

Dr. Juanjo Duque’ has three aesthetic medicine clinics:

In Mexico City, at Prolongación Paseo de la Reforma 627, suite 701 in Santa Fe (appointments can be made through Rocio at 33-1020-0718).

And at Calle Ámsterdam 212, 8th floor, in Colonia Condesa (appointments can be made through Florencia at 55-4868-7685).

And in Guadalajara, at Calle Cordoba 2473, between Rubén Dario and Ontario Providencia (appointments can be made through Carlos at 33-2834-1164).

 Appointments can also be made through the Citas Clínicas service by calling 55-4714-4992.