My Approach to Facial Architecture: A Journey of Precision and Balance
The way I assess a patient’s face has changed dramatically over the years. It’s no longer just about treating the signs of aging. Today, my consultation is a blend of experience, aesthetic medicine, and a deep understanding of dental occlusion. This allows me to see not only what is aging but also what is structurally off. Many patients come to me saying, "I don’t like my face shape, but I can’t pinpoint why. Can you help me?" That vague dissatisfaction is often rooted in skeletal or dental imbalances that become more apparent with time. So my treatment planning always has two pillars: anti-aging and facial structure correction.
Measuring the Facial Thirds
I begin every clinical assessment by analyzing the three facial thirds. I use a simple ruler—though I once used a fancy caliper, a ruler works just as well. The upper third runs from the hairline to the glabella. The middle third goes from the glabella to the subnasal point. The lower third spans from the base of the nose to the chin. The crucial insight is that only the lower third is truly modifiable with injectables. And it is also the area where the most visible changes occur. If the lower third is shorter than the others, it often means the patient has a reduced vertical dimension—the teeth are closed too much. That immediately flags a need to increase length in that area.
I do the same for the side profile. Side profile balancing is one of the most popular treatments in my practice. Using my ruler, I focus on the lower third again. With experience, I have become very selective: I treat the mid and lower thirds with microcannulas, but I avoid the upper third entirely. The more patients I see, the more complications I witness—on myself, on my colleagues—and the safer I become. That is why I rely on SoftFil cannulas for nearly everything.
How Dental Occlusion Shapes the Face
My dental background becomes invaluable here. When I analyze the lower third from the side, I start to visualize the patient’s dental occlusion. The ideal is called Class I occlusion, where the teeth and jaw align centrally. If a patient with a Class I profile comes to me requesting chin filler, I measure the thirds and see they are equal. I explain that adding chin projection would create a pointy, overelongated look. So I decline.
The most common malocclusion I encounter is Class II. Here, the upper jaw is overprojected relative to the lower jaw. The profile appears convex, often with an overprojecting upper lip, a dorsal hump on the nose, and a weak chin. My treatment plan is intuitive: this patient needs projection of the lower lip and chin. If they ask for upper lip filler, I gently refuse. Filling the upper lip would exaggerate the convex profile. Instead, I either leave the upper lip untouched or only enhance the lower lip, then add chin projection. Sometimes a combination of nonsurgical nose reshaping and chin filler is ideal, but the nose is not the real problem—it is the position of the jaws.
The opposite is Class III malocclusion: a prognathic mandible (overdeveloped lower jaw) and a retrognathic maxilla (underprojected upper jaw). The profile is concave. Here, I cannot shorten the chin or lower lip, but I can create projection in the upper lip. A subtle tweak with a 25-gauge cannula balances the entire side profile. We cannot correct the underlying skeletal issue, but we can effectively hide it.
Why Microcannulas Are My Tool of Choice
For all these cases, I use SoftFil microcannulas. There are two types I rely on: the Easy Guide and the Precision. The Easy Guide is a game-changer. It consists of a tiny butterfly-shaped device with a pre-hole needle and a built-in guide for the cannula. All I do is create the entry point with that butterfly, leave it in place, and the cannula slides in effortlessly. I no longer have to search for the hole—everything is pre-aligned. When I started my aesthetic journey twelve years ago, having this tool would have made my life so much easier.
The Precision cannula is equally valuable for fine-tuning. Together, they allow me to place filler exactly where it is needed—safely, with minimal trauma, and with natural results. My philosophy has always been less is more. Subtle aesthetic tweaks that enhance inner beauty without distorting the face. That is what these cannulas deliver.
Bringing It All Together
Every consultation becomes a story of balance. I measure, I analyze the occlusion, I plan the lower third. Whether it is a Class II profile needing chin projection or a Class III profile needing upper lip volume, the decision is driven by the underlying dental skeleton. The cannula is just the instrument that executes this vision—precisely, safely, and beautifully.
This approach has transformed not only my outcomes but also my patients’ confidence. They come in unsure of what they need, and they leave with a face that finally feels harmonious. And that is the true power of understanding facial architecture.