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Aesthetics Practice Today

Balance and Harmony in Facial Aesthetics

Published June 11, 2013 1:10 PM by Mina Grasso
Safety used to be the first concern patients would have when they come in for consultations for aesthetic treatments with facial injectables. Several years ago unsafe practices with unapproved FDA products had much media attention. Patients are more cautious, do more research and read online social media reviews prior to their arrival to our clinic.

The most common concern new patients present with now is the fear of looking overdone or unnatural. Patients usually say they don't want it to look obvious that they had something done. They can usually name a handful of people they know who have "had something done." They have described an unnatural or overdone look as "ducky lips," "trout pout" or "monkey-like" appearance. What they are seeing is a disproportion - a distortion of balance.

Patient education on facial anatomy with changes in the skin, bone and fat that occur during the aging process allows them to understand my global approach to a liquid facelift. I emphasize that my goal is to give them a more refreshed and rested appearance while keeping balance and harmony. I invite patients to bring in photos of them 10-30 years younger which allows me to show them areas of volume loss that they are not aware of.

One of the most challenging areas is the upper lip with deep vertical lines. Although patients hope to get rid of all the lines, I treat this area conservatively to avoid distorting the proportions of beauty. When I treat upper lip vertical lines or enhance the shape or size, I also place some filler in the lower lip as well to help create balance. Allowing patients to look in the mirror at various angles, especially profile view, develops a better understanding. 

In an attempt to help meet the patient's goal while maintaining balance and harmony, sometimes combing injectable fillers with a neurotoxin, fractional resurfacing or other modalities may be a more optimal approach.   

It takes more time to explain and educate patients than it does to just inject and chase the lines that they are focused on, but when they understand, they can feel more confident that they wont look overdone or unnatural - just refreshed.

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    Occupation: Physician Assistant/Nurse Practitioner
    Setting: Miami & Upland, Calif.
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