Balance and Harmony in Facial Aesthetics
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
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.