โ€œMore and more men in positions of power are coming in for procedures,โ€ said Patricia Wexler, New York pre-eminent plastic surgeon to the stars, who estimates that over 30 percent of her cashed-up clientele is now men. โ€œThey are working later in life and are afraid of being aged out.โ€

For the record: Dr. Wexler, who has not treated Putin, suspects that, in addition to the liberal amounts of military-grade Botox and fillers in his face, his โ€œwindswept lookโ€ might be the result of an eye lift and a fat draft to remove bags from under his formerly sunken eyes.

Wexler is not alone in noticing the embrace of injectables among masters of the universe and their aspirants. Said Diane Walder, a Miami-based surgeon who tends to the frown lines, sagging necks and spare tires of chief executives, NFL players and Latin American politicians, among others: โ€œItโ€™s definitely not just gays and celebrities any more. With the emergence of a new breed of tech CEOs about 15 years ago, the fear among men is that if they havenโ€™t made it by 28 theyโ€™re obsolete. In that competitive climate, no one wants to look tired or stressed.โ€

The gateway procedure for most men remains Botox, a muscle-relaxing neurotoxin that was originally developed to treat eye problems but is now injected directly into muscle to help with worrisome expression lines like โ€œpuppet mouthโ€ and โ€œthe 11โ€™sโ€ that form between the eyebrows.

โ€œThey see that a little goes a long way,โ€ explained Jennifer Leebow, director of national education for Botox Labb, a national company with locations in Miami Beach and Los Angeles. โ€œOnce they have Botox and realize how confident it makes them feel, and they find out that if I inject a little bit of hyaluronic acid under their eyes it will get rid of those bags that have been bugging them, itโ€™s not a big leap to get them to try something new.โ€