The newest way to administer injections comes from an idea as old as the golden ratio and as novel as the latest batch of TikTok filters. Enter facial balancing with fillers: an increasingly popular method of subtly altering your face to mathematically harmonious proportions with zero downtime.
“It can be traced back to the classic proportions used in ancient Grecian sculpture,” says Dr. Melissa Doft, MD, a double board-certified plastic surgeon and clinical assistant professor of surgery at Weill Cornell Medical College. “What’s new is that more people are thinking about classic proportions.”
Like any filler treatment, facial balancing done by an injector is completely noninvasive, making it an appealing choice for anyone that wants visible results immediately. That said, ask any expert and they’ll tell you that it’s still a delicate procedure that comes with its own set of limitations. Ahead, TZR tapped top dermatologists and plastic surgeons to find out everything you need to know about this trending injection technique before you book your appointment — from total costs to pros and cons.
What Is Facial Balancing With Fillers?
According to Dr. Doft, many of the techniques now possible with filler are traditionally focused on during plastic surgery training. Rather than completely perfect symmetry, facial balancing starts with a basic understanding how a face can be divided into thirds from top to bottom. If the bottom third of a patient’s face is proportionately too small, a surgeon or dermatologist can enhance the chin or jaw with filler. “Facial balancing means that facial structures like your nose, chin, and cheeks need to be in a certain proportion,” says Dr. Doft.
Not all dermatologists and surgeons will necessarily refer to the technique by this name. Dr. Loretta Ciraldo, MD, a Miami-based board-certified dermatologist and founder of Dr. Loretta skin care, says she uses facial balancing “almost exclusively” in her practice but doesn’t label it as such. “When hyaluronic acid fillers were first approved, the standard approach was to correct lines by injecting directly into areas like mouth-to-nose creases,” she says. “Decades of experience with dermal fillers have taught advanced injectors this approach doesn’t address the whole aging face and often can lead to imbalance.” That said, ask any experienced injector for a facial balancing appointment, and they’ll know what you want.
What Are The Most Popular Types Of Facial Balancing?
Facial balancing takes a holistic approach to each patient’s unique face, which means everyone’s procedure should be tailored to their features. Still, injectors say that certain examples of facial balancing are especially popular in their practices. Dr. Dendy Engelman, MD, a board-certified cosmetic dermatologist and Mohs surgeon at New York’s Shafer Clinic, frequently uses filler to restore areas with volume loss. “When administered properly, it effectively lifts and restores structure to the face,” she says. Popular examples at her practice involve injecting Juvéderm at the cheekbones “for a contoured look and youthful volume,” buccal area (midface), jawline, and chin, depending on her patient’s needs. She also recommends Juvéderm for filling any hollows in the under eye area.
In Dr. Doft’s practice, the most common example is balancing a patient’s nose and chin so that the lower two-thirds of their face remain in proportion. If a patient’s nose appears “too big” for their chin, she adds filler to the chin area to help offset the ratio.
Dr. Ciraldo tends to focus her facial balancing treatments on mid-face injections, targeting the cheekbone area to correct any flattening that’s common once patients reach their early forties. To balance nasolabial folds, she creates a lifted effect by injecting filler into the hairline in front of the ears. “It lessens the depth of the folds and also lifts the face,” she says.
What Are The Pros And Cons Of Facial Balancing With Fillers?
The most obvious downside of facial balancing with fillers: It comes with limitations. “The negative of fillers is that they can only balance the face by adding volume, whereas plastic surgery allows for addition, subtraction, refinement and shape change,” says Dr. Doft. In the hands of an inexperienced injector, adding too much volume “can distort anatomy,” giving the opposite effect of what a facial balancing treatment is meant to provide.
Still, many patients choose filler to avoid the commitment and healing time that inevitably comes with surgery. “It’s a much faster procedure that can be done in less than an hour at your dermatologist’s office with no anesthesia, just a topical numbing cream,” says Dr. Engelman. The temporary effects are a pro for some, and a con for others. Dr. Engelman estimates that results fade “within six to 18 months,” depending on the type of filler you get. But, that can be a good thing for anyone that’s unsure about changing their facial proportions. Some patients also do a test run with fillers before going under the knife. “Commonly, they’ll use fillers in their chin to balance their nose or the upper two-thirds of their face and later opt for a chin implant,” says Dr. Doft.
How Much Does Facial Balancing With Fillers Cost?
Filler costs vary widely by location, so do your research and consult your injector for the most accurate price range. Total costs also depend on the amount of filler used for your specific case. Dr. Doft estimates that the cost for facial balancing starts at $850 and goes up from there, depending on how many vials of filler you need. Your full treatment should include “about 30 minutes to analyze your face, review aesthetic goals, and perform the injections.”
Age also plays a factor. Dr. Ciraldo says that most patients under 40 pay between $2,000-$4,000 “if longer-lasting fillers from Juvéderm or Restylane are used.” For her patients in their later 40s and up, final costs typically add up to more than $4,000 “to achieve optimal results.”
What Should You Expect During Your Consultation & Appointment?
Prep for your facial balancing appointment the way you would any filler treatment. This includes avoiding alcohol, aspirin, and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen the three days leading up to your appointment to minimize the risk of bruising. Dr. Ciraldo also recommends removing fish oil and strong exfoliants from your routine during this window.
Arrive prepared to discuss exactly what you want to accomplish. “Come to a facial balancing consultation with questions and concerns, a good idea of which areas you want to target, and what you want the overall results to look like,” says Dr. Engelman. Your dermatologist or plastic surgeon will assess your facial structure and discuss what’s feasible. “It’s also crucial for doctors to be honest with their patients and set realistic expectations for results,” she says.
Once your treatment is done, a few basic aftercare tips will help minimize the chance of swelling, bruising, and discomfort. Dr. Ciraldo recommends that patients avoid working out for 24 hours and have ice ready at home to soothe injection sites. You can also try sleeping on multiple pillows to minimize swelling.
Dr. Engelman says that results of a facial balancing treatment sometimes take a few weeks to fully settle in, but once they do, you’re free to admire your newly proportionate face until it’s time to book a top-up. And if you’ve got a separate filler appointment coming up? Consider talking to your injector about facial balancing, regardless of which area you’re targeting. “The most natural and satisfying outcomes to filler treatments are when we respect facial balancing,” says Dr. Ciraldo.