Meet the Men Paying to Have Their Jaws Broken in the Name of “Manliness”
Ali—all I can tell you about him is that he’s a young man in his twenties who lives in Western Europe—is pacing up and down the streets of Rome, killing time. The last time he was in the city, Ali managed to fit in some sightseeing: visiting the Vatican, checking out the Colosseum. But on this occasion he’s feeling too nervous for gladiators or crucifixions. You would feel nervous, though, the night before paying someone $21,000 (€20,000) to break your jaw.
Until then, Ali’s killing time. That’s why he’s talking to me. It’s lonely out there, away from home, edging towards anaesthesia. We’re on video call, but his camera is switched off so I can’t see his face. I figure he’s not ready to share it yet. Besides, this is the “before” phase. With any luck, he’ll emerge from the operating theater tomorrow looking like an entirely different person. A man with a strong jaw.
The medical terms for his procedures are a bilateral sagittal split osteotomy, a Le Fort 1 osteotomy, and a genioplasty. After splitting Ali’s lower jaw, upper jaw and chin respectively, surgeons will bolt the pieces of bone back together, restructuring—and advancing—Ali’s jawline.
Ali (not his real name) has been waiting for this day since 2020, when, amid the stasis of the pandemic, he began reaching out to cosmetic surgeons. But the seed was sown much earlier, in his teens, when Ali first felt himself fall behind his “better-looking” friends. As he saw it, they had no problem getting girlfriends, whereas he struggled. He didn’t consider himself ugly, but the guys around him seemed to channel a different sort of energy. It was crushing to see the genetic lottery at play; even more so when some of his friends were scouted as models. Online dating—the cold, hard stats of a low match count – only put the feeling into numbers.
Ali considers himself a deep thinker, “philosophical.” As a teenager he was a smart kid, albeit a little lazy, with a good memory and an eye for detail, which helped him start a career in engineering. Professionally, he applied that skill to technical drawings, construction blueprints. Privately, that instinct lazered in on the building blocks of his face.
In 2019, Ali started hanging out on Looksmax.org, an online forum in which men strive to achieve their “aesthetic potential”. Looksmaxing is a facet of the manosphere, that swamp of online communities that’s often a potent mix of toxic masculinity, men’s rights and misogyny. There, one can encounter a whole array of influencers, from pickup artists and provocateurs like Jordan Peterson to self-proclaimed misogynists like Andrew Tate. The manosphere is dominated by “red pill” ideology, which references the scene in The Matrix when Neo chooses to take a red capsule instead of a blue one and, in so doing, see the world as it truly is. To be “redpilled” can refer to any unsettling awakening; in this particular context, it describes an understanding of society in which modern men have become disadvantaged by a feminist power shift that leaves them unable to find sexual partners. Women, meanwhile—or so the distorted logic goes—can take their pick.
Deeper and more dangerous than the red pill is a worldview known as the “black pill.” Blackpillers believe almost every element of life can be determined by your physical appearance and the genetic hand you’ve been dealt. According to their brand of biological essentialism, relationships are largely a primal transaction. While Redpillers believe that they can attract a partner by triggering women’s supposed subconscious desire for an “alpha” mate—through money or so-called “game”—blackpillers believe those who don’t meet a certain threshold of attractiveness don’t stand a chance.
As you would expect for a forum with these ideas pulsing through it, Looksmax.org is home to pages of sexist and racist vitriol, but also detailed skin care tips and in-depth advice about gut health (although the site’s disclaimer specifies that it is not an alternative to medical advice). Ali didn’t identify with the incels; they were too despairing, he says, “the true troubled souls.” But he found the discussions about “lookism”—prejudice on the basis of appearance—convincing. He began to contribute in earnest, helping to compile guides and offering advice. Working on himself felt optimistic. In its own murky way, it was empowering. “It’s a community of people trying to look better and help each other,” he says.
The forum became a testing ground for Ali’s theories about personal appearance. A place to scour images of male models and find the common denominators in their appearances. He noticed that they have “certain shapes, certain facial structures… you start to get a database in your head.” Ali liked to look good: he went to the gym; he wasn’t overweight; he had a skin care regimen. But this mental database illuminated what—to him—now seemed to be his biggest flaws, which were confirmed bluntly when he posted a photo to the forum. His profile? Unsatisfactory. Jawline? Lacking definition. Chin? “Too close to my neck.”
Over time, Ali came to believe that it wasn’t just dating where a man’s appearance was an unspoken decider, but all the trappings of an aspirational lifestyle. “Generally we all want success in life,” he says. “And I came to the conclusion that if you are better looking—and better looking can be a really broad spectrum group—then you have better chances.”
It seemed that everything from his love life to his career could be boosted with an adjustment to this part of his face. Those “few millimetres of bone,” as incels often wail, between being hot or not. He booked the surgery, and boarded his flight.
Henry Cavill. George Clooney. Robert Pattinson. (Any Batman, in fact.) Watch any Hollywood movie, flick through any fashion magazine, turn on Love Island and you’ll find the male faces you encounter are all carved in the same, angular form—a solid block of bone hanging below the face, prepped to block punches like a stubbly brick wall.
It wasn’t always this way. (Check out some classical frescos.) Nor is it a globally unified ideal: in China and Korea, men flock for surgery to have their jawlines softened, and feel no less manly for it. According to facial surgeon Hermann Sailer, it wasn’t until the 1930s and 40s that the desirability of the so-called “anteface”—a face with forward protrusion of features—began to take hold in the West. But amplified by Hollywood and ever-more-visual media, that —zero buccal fat, cheese-wire mandible, dimpled chin—has become a stereotype, and shorthand for a certain dominant masculinity.
Roll back the clock a hundred years and there wasn’t much you could do; your jawline, or lack of it, was up to genetics. Then, in the late 20th century, commercial plastic surgery arrived and—for good or ill—suddenly anyone with enough money could buy the face they wanted. As technology has advanced, bringing with it cheaper, and less invasive procedures like injectable fillers and Botox, the “superhero jawline,” or the “GI Jaw,” as one surgeon has marketed it, is increasingly available to all.
Jaw surgery has typically been a corrective measure—used to address medical issues, or among men transitioning. But men seeking cosmetic alterations, by either surgery or syringe, have snowballed since the pandemic, when the so-called “Zoom effect”—staring at yourself from unflattering angles all day—prompted a spike in requests for consultations. (According to The Aesthetics Society, the Zoom effect explains the 55 percent increase in men and women getting facial procedures in 2021.) Writing in Newsweek last year, plastic surgeon Dr Richard Westreich said that chin implants are his second most common male procedure, frequently alongside “submentoplasty; a surgical tightening of the jawline that creates more definition.” The result is youthful, slimming, ‘grammable.
It is precisely this effect that has led some men to start using injectable cosmetics. “Masculinisation fillers” are now being marketed by clinics as a lunch-break indulgence. TikTok teems with clips depicting jawline sculpting and “male model makeovers.” On YouTube and Instagram, videos drill into the “rule of facial thirds” and the science of the ideal profile, explaining the likes of the Golden Ratio (supposedly the perfect face should be 1.618 times longer than it is wide). Startups like Qoves Studio have begun to offer facial “aesthetics assessments” using AI. On Reddit, men post before and after pics for public scrutiny. As one poster wrote on r/JawSurgery in July 2022: “I don’t know what’s causing it, or where people keep getting the idea that they need jaw surgery, but it is out of control.”
Within the looksmaxing community, this fixation on mandibular aesthetics has generated a vast rabbit hole of content to tumble into. Ali sends me a link to one video, “How to rate the attractiveness of the eyes—part 3 (blackpill analysis)”, which discusses the importance of the angle of the lateral canthus (where the upper and lower eyelids meet) in relation to the medial canthus. One of the first comments is an essay-length response in which someone argues that the “jaw is law” and a weak jaw and chin is a “deadly combo”. (The ideal gonial angle—that’s the corner of your jawline where it curves up to your ear—is 112–118 degrees, if you were wondering.)
In other threads, celebrities such as Brad Pitt, David Gandy and Jeremy Meeks (the model formerly known as the “hot convict”) are idolized for their maxed-out masseters (jaw muscles) and the contours of their lower third. Incels in particular obsess over the “Chad” bone structure: “alpha” men with broad, angular jaws and “hunter eyes”. Many spend time “mewing”—a scientifically contentious set of tongue exercises developed by a British orthodontist, Jonathan Mew, which purportedly sharpens your jawline; on TikTok, #mewing videos now have over two billion views. Companies like Jawzrsize have also capitalised on the trend, marketing a silicon training ball with which to chew your way to alpha-dom.
This sort of content can have a powerful effect, particularly on younger and more insecure men. Men like Ted. Ted (also not his real name) always thought something was a little “atypical” about his face. Nothing to cause any particular agitation, just a fact that he would occasionally observe. The first time we speak, also over video call, he flashes onto the screen—fair hair and glasses combined for a geeky, cherubic charm—then makes an excuse to turn his camera off. Ted grew up in the suburbs in the American Midwest, then moved to Silicon Valley via Stanford. If he were to describe himself, it would be “eccentric and entrepreneurial.” At least, that’s what he puts on his dating profile. To his friends, he’s a “tech bro in denial.”
Ted, 27, was researching jaw surgery to fix his sleep apnea, and was excited to discover the visual improvement it could deliver. But as he researched the surgery, he fell into the “dark, macabre internet rabbit hole of aesthetics.” He posted a photo of his face on one forum, “just to be like, ‘hey, am I recessed?’” The criticisms came thick and fast. “It didn’t ruin my day or anything, but it definitely stung for a week or so,” he tells me. “And I imagine that would really hurt to a 15-year-old boy who stumbled across this.”
Ted had his surgery in May 2021, with Derek Steinbacher, a leading maxillofacial surgeon based in Connecticut. He is still pretty excited about it. The first time he saw his face afterwards was when he got up to use the bathroom, looked in the mirror and saw “an alien” looking back at him. Then he realized he was pissing blood everywhere as a result of a catheter inserted during the operation, and he was in agonizing pain because, well, his face had been cut open five hours earlier.
Now, Ted says, “jaw surgery is my special subject at parties.” Although he is yet to experience any meaningful changes to his life—it hasn’t actually affected his career or relationships, at least, not yet—he certainly feels more confident. He’s already noticed a subtle difference in the way people treat him. His friends call him “Chad” now, for starters. “You can quote me on this,” he says: “the incels were right.”
Then there’s Miguel (also not his real name), who is in his mid-30s, lives in Spain and works in tourism. Miguel discovered the looksmaxing community in 2020, and between the “trolls and sexless teens” he found himself impressed by the technical discussion of aesthetics: facial ratios, surgeries, anatomy, how the jaw “makes or breaks a face.” Like Ted, Miguel always thought something was “off” about his appearance, but until then, couldn’t tell what it was. “Unfortunately, knowing my flaws made me more aware of them,” he says. “I also learned about jaw surgery, which I didn’t even know existed before. I immediately knew I needed to have it.”
There are a number of specialist maxillofacial surgeons around the world with a reputation as masters of jaw surgery. Professor Hermann Sailer, who is based in Switzerland; Professor Mirco Raffaini, in Italy; Dr Paul Coceancig in Australia. The names bounce around the forums and roll off the tongues of the people I speak to. Miguel knew he wanted to go with one of the best, and aesthetics were top of his list, so he booked a consultation with Dr Federico Hernández Alfaro at the Instituto Maxilofacial in Barcelona.
The Teknon Medical Centre is a palatial private hospital in one of Barcelona’s upmarket neighborhoods, surrounded by a maze of hedges and palm trees that leads up to the entrance. The office of Dr Federico Hernández Alfaro, the director of the Instituto Maxilofacial, is on the top floor. It’s the best in the hospital, he tells me, a glass corner room that looks over the skyline, trees and sun-drenched rooftops that tumble down to the Mediterranean. On the rear wall is a bookcase decorated with pieces of cranium and jawbones among brightly painted ceramic calaveras—decorative skulls—from Alfaro’s regular holidays to Mexico.
If cosmetic surgeons are a type, then Alfaro is it: glowing skin, white teeth, a Rolex glinting on his wrist. He’s charming, confident, athletic—the sort of man that many men aspire to be. In his spare time he likes to kitesurf, a habit he picked up after going through a divorce (“Some people choose therapy,” he says). Some days he whizzes from the hospital down to the coast on his scooter to catch the breeze.
Alfaro has performed around 5,000 surgeries in his career. In the past, he says, most were remedial—to fix serious problems with the bite, or to address breathing problems such as sleep apnea. But Alfaro would find patients asking him, “I know you can fix my bite, but can you make my face look better?” Over the years, Alfaro has developed his own “orthofacial” approach. (There’s even an Alfaro-brand reference point, “the Barcelona line”, which is used to determine the optimal advancement of the mandible.) The way he sees it, the tweaks that other people pursue with Botox, fillers, implants and lifts can all be resolved with artful engineering of the skull. Repositioning the jaw, he explains, can “harmonise” the face. Moving it forward can balance out a large nose; it can plump the lips; vanish a double chin.
Alfaro currently conducts 200 orthofacial surgeries a year. His rate of patients has doubled in the past five years, largely thanks to an influx of international patients. The majority of these used to be women; now it’s a 50/50 split. “Just like men are now more concerned about their skincare, how they dress, I think the same pattern is followed with facial aesthetics,” he says.
Most of his male patients, Alfaro says, are lawyers, engineers, and doctors. But tech workers make up a substantial proportion of his international clientele. “They spend their lives in front of the computer and are very easily able to search for resources,” he says. “They show up saying, ‘Yeah doc, I need a maxillomandibular advancement with a counter-clockwise rotation and a six-, seven-millimetre genioplasty…’ They are able to study their faces to a degree that scares me sometimes.”
The pandemic further accelerated this effect. Alfaro tells me about one patient who was unaware of having a problem until they had to spend hours in front of the computer staring at their weak mandible, their double chin. “More and more patients come to me saying they can’t upload a photo of themselves to Instagram without manipulating it,” he says.
Until recently, most people wouldn’t seek such a serious surgery unless they had medical reasons. Patients would spend hours in theatre, probably need a blood transfusion and take weeks—months—to recover. But Alfaro can reposition the upper and lower jaw in 90 minutes; patients are usually discharged the following morning. He’s proud of his work, and invites me along to watch.
For Alfaro, surgery day starts with a cold shower and a gym session. Today is no different. He arrives at the theatre clear-headed, places his phone and Rolex on a desk, mounts a head torch and bows his head for a moment of meditation. A young man is wheeled in on a bed, and the anaesthetist places a mask over his face. A photo of his smiling face is visible on a monitor, alongside 3D scans of his skull. This particular gentleman is here to have his jaw advanced. “For aesthetic reasons, he also needs a rhinoplasty,” says Alfaro, “but he’s going to see the results of this first.” The team set to work, pirouetting around each other as they administer lidocaine and adrenaline injections. A table of unsettling instruments is rolled close. “Have you had breakfast?” Alfaro asks, and reaches for the ultrasonic scalpel.
The surgery is done through the mouth. First, the wisdom teeth are removed. Then more buzzing, as the mandible is cut. Alfaro asks for the music to be turned up—Britpop and indie—and then reaches for the hammer and chisel. “I think of myself as a sophisticated carpenter,” he says. There’s a crack, like the splintering of a lobster shell, and the front section of the man’s mandible, the lower jaw, is completely detached. Alfaro moves it forward into position using a splint to match it with the top jaw and fixes it into place with titanium plates that can remain in the body. The same process is conducted with the maxilla, the upper jaw, which Alfaro is able to detach via a small incision in the gum, part of a set of “minimally invasive” techniques that speed up recovery. Whirr. Tap, tap. Crack. “Shark Smile” by Big Thief plays in the background. The top jaw is positioned with another splint and locked into place.
To the tune of “Common People”, by Pulp, Alfaro shaves down a block of artificial bone to plug the gap in the jaw, and we’re done. He looks at the clock. One hour 32 minutes. “See how his nose doesn’t look so big now?” Alfaro says, admiring his work. “And his lips are projected.” A cold water mask is wrapped around the patient’s face, and he is wheeled off to recovery. In 30 minutes or so it will be time for the next one.
Alfaro always has an appetite after surgery (he actually loses weight, he says, from the concentration), so afterwards we head next door to a private health club for lunch. I ask Alfaro if he’s encountered the looksmaxing community, or incels. “I think we’ve heard from some of those”, he says. Some people show up with 20 photos of celebrities on their phone and want to look exactly like them. Or want to change their racial appearance. Or want radical changes that are just impossible to achieve. Alfaro’s marketing assistant, Maya Martinez, tells me they try to spot any red flags and direct those people to a psychologist. But picking up on mental health issues, or people with body dysmorphia, is one of the biggest challenges for cosmetic surgeons. I’m told the Instituto turns away around 15 per cent of prospective patients.
What about those who believe that surgery will improve their life? “It happens that some patients, when they achieve a normal or attractive face, they perform better in life,” says Alfaro. “But if that’s your main objective, I cannot guarantee it. I can place your bones in the optimal position to maximize your facial aesthetics, but there are some things in your face that cannot be changed. And nothing in your brain can be changed with my surgery.” He elegantly carves a piece of roast chicken from his plate and takes a bite. “We often see patients who expect too much out of surgery,” he says. “I cannot change your personality.”
Six hours after signing the paperwork, Ali emerged from the operating theatre in Rome. He regained consciousness and felt surprisingly energetic, but was unable to walk, use the toilet, or eat. He shares some photos of himself post-surgery, his swollen face wrapped up in bandages. A mop of disheveled hair. Dark blood around his nose. He also shares some of his “before” photos, portraits he’s used for his dating profile. He’s well-groomed, donning a patterned shirt, striking poses in a park. He looks sweet, earnest, albeit a little uncomfortable in his own skin. It’s a vulnerable juxtaposition.
Ali spent that first day video-calling his friends and family, then was discharged to recover for a few more days in his Airbnb. There, he told me, he spent time looking in the mirror. Seeing his swollen face wrapped up in bandages staring back at him, he started to feel his anxiety rising. “I took a big gamble,” he says. “I started to struggle mentally, thinking, ‘What have I done? I’ve broken my entire face to look better and I don’t even look better now.’” All he could do, he said, was sip liquids and wait for the swelling to go down.
Love, and the pursuit of it, has never felt more like a marketplace. On dating apps from Tinder to Feeld, and even on more everyday social media, we now view ourselves as brands, vying for investment from potential matches. “You’ve got almost infinite choice,” says Ruth Holliday, a professor of gender and culture at the University of Leeds. “Then, at the same time, everybody’s trying to maximise their own possibilities.”
“And some men are just excluded from that,” she continues. “They fall off the bottom because they haven’t got a good job or stable income. They’re not particularly good-looking either, and then they withdraw and become incels and get angry with women from the sidelines.”
The red pill and black pill ideologies can harness this resentment, immolate it, and drive people to despair. For those that identify as “incels” (the term originally meant ‘involuntarily celibate’), the black pill is a particularly nihilistic truth to swallow. It can lead to suicidal ideation, violence and even acts of terror: in 2014, a gunman killed six students at the University of California before killing himself, after posting about his inability to form a relationship and calling for further violence against women. The call was taken up by another gunman, who killed 10 people in Toronto in 2018. In 2021, a self-identified incel killed five people in Plymouth. Fixation on a vision of masculinity that leads some men to choose jaw surgery can lead others to hatred.
Manosphere communities are often rooted in loneliness, insecurity and a feeling of being disempowered. It’s the same anxiety that is driving a record number of men to pay for hair transplants, Botox, and even leg-lengthening surgery; the desire to look healthy, youthful, competitive. Prejudice on the basis of appearance is real (though it is undoubtedly most acutely felt in the form of racism, or by those with disabilities or deformities). But even Daniel Hamermesh, an economist who quantified this effect in his book, Beauty Pays, concluded that investment in looks, whether through surgery, fashion or cosmetics, was usually limited in its returns. “Bad looks,” he wrote, “are not a crucial disadvantage, not something that our own actions cannot at least partly overcome, and not something whose burden should be so overwhelming as to crush our spirit.” As Kjerstin Gruys, author of Mirror, Mirror Off the Wall, has said, while those at the extreme ends of the beauty scale may have vastly different experiences in life, most of us are (sadly… or happily) pretty average.
“I hope you see the moral dilemma,” Ali wrote in an email full of links to related videos and articles, “Looks affects our life that is for sure, but to what degree? Is it worth to change it? [sic] And in what circumstances not?”
That men are increasingly sensitive to – and compelled to act on – anxieties long felt by women is a sign of shifting ideas around masculinity. And although the manosphere sells jaw surgery as a chance to reclaim an “alpha” manhood under threat, the motivations for men to receive cosmetic procedures are as varied as men themselves.
For Sam Batterbury, 23, an animator from Canada, the choice to get chin and nose surgery was an empowered one. “I like to live outrageously and I guess, in our culture, getting a bunch of silicon in your chin is outrageous,” he says. Sam is bisexual; the icons he looks up to—Prince and Bowie— challenged the normative image of men and are a far cry from the likes of Andrew Tate (who, as many looksmaxers point out, actually has a receding jaw). Besides, he tells me, “I think you should be allowed to feel better about yourself for the sake of feeling better about yourself.”
Michéll Miodek, 35, from Sweden, underwent jaw surgery in response to crippling insecurity about his appearance that had impacted his mental health throughout his life. He remembers being taunted in the street, and would get anxious talking to people in the car, because they could see his profile. He chose the procedure after stumbling across an Instagram ad for Alfaro’s clinic. He was still wearing braces, he tells me, when he went on his first date after the operation, but felt confident enough to explain what he’d been through. They hit it off; they are now married and expecting their first child.
When I mentioned looksmaxing to Michéll, he looks at me blankly; he’d never heard of it. But most of the men I spoke to had encountered the gravitational pull of online communities bubbling with misogyny. Women (who remain by far the dominant consumer of cosmetic procedures) are constantly pressured into body dysmorphia and self-loathing, but it is uniquely troubling that so many men are seeking solace in communities lacking in empathy for the very people they seek to attract. It’s not always clear where Ali really stands on gender dynamics, having spent so much time immersed in those spaces. I ask if his experience has led him to empathise more with women and the stresses they experience. “I can understand the struggles,” he says. “I have a lot of empathy for people who are not good-looking.”
A couple of weeks later, I check in with Ali again. He’s at his mum’s house, recovering well and feeling more comfortable—and confident—in his new face. He’s wearing a gray hoodie and a beard, which he apologizes for; he’s still feeling too sensitive around his chin to shave. He looks a little swollen, but the change is evident: the contours of his lower third are more clearly pronounced. I ask if he’s happy with the results. “Well, it could have gone further,” he says, rubbing his bristles. “My surgeon was more conservative.” But he wouldn’t go back, even if it would deliver enhanced results. He underestimated the psychological impact of surgery, he tells me. It has been a challenging few weeks.
I ask if the forums have some responsibility for that: normalizing invasive medical procedures. He nods. “People talk way too easily about surgery,” he says. “People say, ‘Just do it, you’ll look better.’” Often, that blasé approach masks deeper problems. Ali was recently contacted by a young man asking about his surgery. He said he was worried about the cost, but was so depressed that if he didn’t have surgery soon he’d kill himself. “What do you say to that?”
Ali is feeling optimistic, though. Another couple of weeks pass and his mental health has begun to improve. He feels like people are being a little nicer to him, strangers offering compliments, which didn’t happen before. He reckons he’s getting checked out too. Recently an older woman kept staring at him at the gym. It actually creeped him out. “I felt sexualized, in a way.”
Lately he’s spending less time on the looksmaxing forums. “I don’t like half the stuff on the forum really,” he says. “I was listening to a podcast where the host made an interesting point about how on these forums you have to be like a thief—you steal all the information then leave the community so you don’t get the toxicity…you need to go in and extract the tiny amount that’s useful and get away.” He’s got plans to start a consultancy to help men who want to look better, drawing on everything he’s learned.
Ali’s got a life coach now. And a dating coach. He showed the latter his profile photos from before and the coach couldn’t see anything wrong with them, which was reassuring, but left him wondering what was causing his lack of matches. He’s looking forward to doing more socalizing out in the real world. “I was trying to reconstruct my hobbies because I was spending too much time on screen,” he says. “I’m trying to reinvent myself.” He tells me about a drama class he went to recently. “We had to connect our emotions to how we move. Like, if you’re dominant you walk a certain way, you talk a certain way. Then we also explored the elements…earth, water, fire. And forgiveness.” He had to put the classes on hold for his surgery, but he’s excited to go back.
“I think I’ve done everything I can do for myself with looks, really,” he says. “Now it’s just about my personality.”
Will Coldwell is a journalist based in London.
This story originally ran on British GQ with the title “Meet the men paying to have their jaws broken in the name of ‘manliness’”
Do you ever feel discouraged? Maybe like you’re not doing enough? I’ve been battling that feeling lately, and it…