When Jeff Bezos, the Amazon kingpin, debuted his new muscular physique at the Sun Valley Conference in 2017, he almost broke the internet. His Vin Dieselesque guns launched countless memes about how the dweebs dweeb had transformed himself into a jacked-up specimen worthy of an action franchise.

In interviews Bezos credits his diet (which includes roast iguana and octopus for breakfast), his unwavering commitment to working out, and eight hours of sleep. But not everyone is buying it.

Clean livingthats the catchphrase, isnt it? quips Patricia Wexler, the ne plus ultra of Manhattan dermatologists. Very few admit to doing any procedures.

Not a chance its just diet and exercise, says Roberta Del Campo, a dermatologist based in Miami, the countrys plastic surgery capital. Behind the scenes these people are getting all sorts of injectables and body sculpting treatments, such as Emsculpt and Trusculpt Flex, which have surged in popularity, especially among men, in the last couple of years.

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Other experts suspect that captains of industry such as Bezos, who is 56, are going to even greater lengths to project vigor for both boards and broads. The tech titans are all looking much better than they used to, says Jessie Cheung, a Chicago-based cosmetic dermatologist whose holistic approach often involves testosterone and growth hormone substitutes, especially for men of a certain age who are lacking in muscle and look frail.

Access to bio-hacking tools such as stem cells and hormones is allowing men to look, perform, and think better. Its worth noting that Bezos, along with fellow billionaire Peter Thiel, invested in Unity Biotechnology, a company researching drugs and treatments to keep aging at bay. Im pretty sure hes gotten a taste of some good stuff, Cheung says.

Welcome to the new male vanity, in which even Silicon Valley bigwigs considerably younger than Bezos are resorting to newfangled procedures to avoid aging out of the workforce. The stakes have never been higher. American men underwent 1.1 million noninvasive cosmetic procedures in 2018a 72 percent increase since 2000, a trend that shows no signs of abating. In its forecast for 2020, the American Society for Aesthetic Plastic Surgery predicts the continued rise of the Daddy-Do-Over, the male equivalent of the Mommy Makeover, as men look to boost their confidence and improve their physical appearance.

Its a lesson in maintenance the men in the presidential race would do well to learn. In the not so distant past politicians could dismiss reporters questions about whether theyd had a face-lift, as Arnold Schwarzenegger did during his 2003 run for governor of California, when he joked that they must be confusing him with Cher. Now pols and pundits of every party are being grilled as mercilessly about their appearance as about their Medicare plans.

"Unfortunately for Biden, you can see the work thats been done," says one NYC dermatologist.

Joe Bidens forehead and Donald Trumps hair flap and skin color are dissected with the rigor of Kremlinologists (some of them actually are Kremlinologists, in Trumps case). And with good reason: If Hillary Clintons wrinkles, Elizabeth Warrens glasses, and Amy Klobuchars eyebrows are fair game, why not the nipped and tucked peacocks strutting around on Capitol Hill?

Denials about the scars on the side of Bidens face are, according to the experts, malarkey. Unfortunately for Biden, who has obviously had hair transplants and Botox, among other things, you can see the work thats been done, says Wexler. Nobody should be talking about work. When you have work done, the last thing you want is for people to notice it.

The queen of Fraxels laser focus on male primping is not partisan. Mr. Trump has definitely had workand not great work, at that, she adds. Give him his crumb, though: He wasnt bad looking when he was younger and in better shape.

Trumps penchant for cosmetic adjustments has been an open if much denied secret since at least 1991, when Ivana Trump disclosed his scalp reduction surgery and chin and waist liposuction in their divorce papers. In February the world was served a fresh reminder, when the president was photographed, in an image that quickly went viral, stepping out of Marine One with a windswept rug and a fake tan for the history books.

At tony dermatologist practices from coast to coast, man-tans like Trumps and obvious old-school work like the kind favored by Vladimir Putin is frowned uponif anyone can move any facial muscles at all. Instead, next-gen lasers such as NeoSkin by Aerolase, IBeam, and Nd:YAG are used to eliminate redness and discoloration.

Instead of surgical face-lifts, which, to be fair, remain popular in certain parts of the country (I definitely see them more on the West Coast, Wexler says, where its been around longer and is more accepted), men of means are turning to noninvasive procedures, most notably Ultherapy, a relatively painless FDA-cleared ultrasound treatment that requires no downtime.

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For the ultimate injection of masculine vigor, though, Cheung works with membersand not necessarily of Congress. We make penises bigger and better, she says. Self-confidence for men is tied up with their penises and how well they work. We give them their swagger back.

Men looking for an extra glide in their stride are considering the augmented Priapus Shot, or P-shot, Cheung says, a treatment thats the male equivalent of the O-shot. She is also increasingly recommending a machine called Emsella, better known as the Orgasm Throne, which generates approximately 11,000 Kegel contractions in 30 minutes (it was originally developed for female incontinence). It really gives you an invigorating kick in the pants, Cheung says.

If the recent past is anything to go by, theres no guarantee that the candidates who end up squaring off in November will provide anything resembling accurate medical recordswhich is a shame, as they would make interesting reading. Like Bezos and less heralded moguls across the country, they are unlikely to reveal any touch-ups to anyone but their best pals.

Men will come in and ask for something their friend has had done, Wexler says. But you wont hear anyone on Jimmy Fallon saying, Im so tired: I was at the dermatologist all day.

This story appears in the May 2020 issue of Town & Country.

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