The term "Brotox" isn't new, but got a boost in January when Good Morning America did a profile on women who think their men need Botox and give it to them as gifts. For those versed in mash-up lingo, "Brotox" went mainstream, joining "bromance" and other "brocabulary" spoken from one "bro" to another.
Men get Botox to look younger and gain confidence. They might be competing for a new job or trying to score a date. Too often, perhaps, people have told them that they look tired.
"Today's man is evolving," Dr Castellano said. "Guys are feeling more comfortable with improving their appearance. They aren't as scared."
Guys prefer Botox over face-lifts and other more extreme, expensive procedures because it's quick without many side effects, he said.
"They can come in for a few shots, then go back to work. And if they don't like the results, they aren't permanent," the doctor said.
Last year, more than 300,000 men got Botox, according to figures from the American Society of Plastic Surgeons. That is a 10 per cent increase from the previous year. Castellano's office in Tampa, Florida, has seen even more. The 39-year-old facial plastic surgeon estimates Botox use among his male clients has doubled. He uses it himself.
Like their female counterparts, more men are starting treatments at a younger age. They prefer not to wait for visible signs of ageing in their 50s and 60s. They want to prevent them.
Lo Balbo, 34, didn't like what he saw in the mirror: new lines on his forehead and around his eyes. A graphic designer, he wants to look presentable for clients. Squinting at a computer all day only worsens the situation.
But when his girlfriend, Heather Knox, recommended they both try some cosmetic pick-me-ups, he refused. What would his friends think? What would he tell people? A little more prodding and Lo Balbo changed his mind. He wanted to support his 31-year-old girlfriend and figured he might like the results.
Getting the news past his roommate, an electrician, was the toughest part. "He was like, 'Really"'
About two weeks after the Botox and facial fillers, Lo Balbo had no regrets. His girlfriend praised his smoother forehead. No one noticed a big change.
A year after starting Botox, Scott Gass, 38, said the differences are subtle but noticeable enough to come back for more every six months.
"I'm getting up there in age a little bit," he said. "Unfortunately, lines come. I just want to look my best," Gass said.
Gass considers himself a masculine guy with metrosexual tendencies. He's single, eats healthy and works out daily. He takes care of himself.
Not many of his friends know he gets Botox, but he doesn't avoid the subject. He likes calling it Brotox. It sounds macho, even hip. He wouldn't frown upon recommending it to his bros.
- AAP