Alcala is like many men, concerned about his job.
"Refresh my face, it's better for my job you know," he said.
He went to a surgeon to help him look younger. But he didn't want surgery. Instead, men tend to choose fillers, a way to replace volume in the face lost to gravity.
Facial plastic surgeon Dr. Russ Kridel is seeing more and more men like Jorge. He used Perlane to fill the deep folds along his nose and mouth.
"You don't see that line you don't see the depression any more, see it's filled out," said facial plastic surgeon Dr Russell Kridel.
As you would expect cosmetic surgeries are down, down 9 percent from 2007-2008. But minimally invasive cosmetic procedures are up 5 percent, and some of that is being driven by the job market.
"Not just because the economy may be down but people may want something less invasive that they don't have to spend more time recovering from," said Dr. Kridel.
"I had a lot of sun damage from growing up in Hawaii," said patient August Milan.
Milan wanted to look younger after moving to Houston. Dr. Kridel filled the usual crease along the nose. But then he filled some unexpected places, her temples.
"People tend to lose a lot of fullness in this temple area here the more you see the shape of the underlying skull, the more it looks like you're getting older so we want to keep that plumped out," said Dr. Kridel.
Another place often overlooked is the aging chin and jaw.
"As a time goes on it tends to hollow out in here," said Dr. Kridel.
The cheeks, as we age, the distance increases between the eye and the round part of your cheeks. Filler closes the gap. The filler Sculptera stimulates your own collagen, so it works more slowly. But it lasts longer -- up to 2 years.
August had the first of three sessions, she says it wasn't painful and even with the swelling, she was pleased.
"It's better than I thought it would be," she said. "I have nicely defined cheeks, everything's smoothed out. It's just amazing.
Dr. Kridel used a filler called Juvederm to fill 38-year-old Debbie Blake's lip and the corners of her mouth. Results are immediate. It takes one session, but lasts only 6 to 9 months.
"They're not overdone, they look natural," said Blake. "I'm very happy."
The cost ranges from $400 to $800. But with the recession, some filler makers are doing something very unusual in medicine: they're offering rebates.
Another new trend, facial fillers are also being used when people do have a face lift. That makes the face look less pulled so it looks more natural.
