7 Important Facts to Know, According to a Surgeon


When it comes to aesthetics, there’s almost no one-size-fits-all solution but, according to New York facial plastic surgeon John Kang, MD, the much-discussed “facial balancing trend” can pretty much benefit everyone—regardless of age, genetics or goals. “Facial balancing is the ultimate attempt at creating ‘natural beauty,’ says Dr. Kang. “The kind of beauty which allows the eyes of the beholder to stay focused onto the subject matter because of the fluid proportions and flattering dynamics as when speaking and expressing.” Without this harmony, the eyes begin to wander away and lose interest he explains. “This is why everyone is a candidate, it’s more about the essence of beauty.”

Here are seven things to know about the multi-faceted treatment.

It is expert-approved: Dr. Kang says facial balancing is an important—and timely—topic because there are so many cases of “excess fillers and fat injection to the face and lips and overdone Botox to the forehead and brows” right now. “In the industry, we often call that ‘marshmallow faces.’ As board-certified professionals in the field of cosmetic enhancement, we need to get back to the basics and advise, emphasize and offer elegant facial balancing to all of our patients.”

It is always in style: It may be no secret that a well-balanced face is a good-looking face, but Dr. Kang says to consider this: “No matter how wide or narrow, plump or gaunt, you can optimize the balance of the eyes, nose, lips, and chin to fit the inherent foundation of the face. But a great-looking face must have balance, as well as a genetically endowed ‘bony foundation.’ Conversely, so many patients with a beautiful and elegant bony foundation mess up their face with too much filler and Botox and unwarranted prematurely early lifting surgeries.”

It has universal appeal: The good news: Everyone is a candidate for a facial-balancing procedure. We all know that in the 25 and younger age group, reducing a large nose hump or bulbous nose tip can deliver a more balanced face,” points out Dr. Kang. “In patients of Asian descent, creating a double eyelid can completely wake up the eye, bringing about more balance. And for those with a slightly small nose, which makes their face proportionally too big, a five-minute ‘filler nose job’ can immediately bring about more balance and harmony, with the option for formal nasal augmentation surgery later. For patients aged 25 to 30 and older, regardless of how beautiful and balanced their face might have been, aging changes inevitably set in. These changes occur because of gravity or deflation from the loss of soft tissue and fat. For these patients, a skilled cosmetic surgeon will recommend a precise combination of energy-based devices and thread lifting to gently counteract the effects of gravity. Additionally, dimensional fat grafting or filler revolumization is used to maintain optimal volume in the face. In 2023, many patients look amazing by engaging in minimal but periodic ongoing efforts to combat the inevitable signs of aging. They can maintain their naturally well-balanced face and successfully postpone the need for invasive lifting surgeries, sometimes indefinitely.”

It is bespoke: This is one “treatment” where your board-certified provider needs to shine, Dr. Kang stresses, adding that it is key for your provider to be able to make accurate analysis of your aging pattern and come up with a bespoke formula to fit your needs. “But the caveat is to accomplish this through means of using the least-invasive techniques available so that your facial balance is natural and not over-done,” he says. “A naturally balanced–looking face can look great, but an unnaturally balanced–looking face—often as the result of too many surgeries—is not great. I cannot overemphasize this enough: Seeking a board-certified surgeon who has decades of training in the inner workings of the anatomy and who has devoted a chunk of their career to understanding the inevitable aging changes and has the versatility to perform both ‘open’ surgeries, as well as the latest state of art ‘closed’ surgeries using the latest minimally invasive tools and techniques, is vital. Do not compromise yourself by seeking a provider who only offers surgical options—or worse, only offers nonsurgical or noninvasive options. This shows their level of training—or lack thereof.”

You’re never too old to consider it: Truth be told, we all appear much more balanced in our youth, thanks to the presence of soft tissue and fat that provide dimensional volume and mask the inherent bony asymmetry between the left and right sides of our face. Dr. Kang explains, “It’s impossible to try looking younger and reverse the hands of time without addressing balance from the beginning.” On the other end of the spectrum, Dr. Kang welcomes patients in their 70s and even those in their 80s, regardless of whether they have previously undergone cosmetic enhancements or aged naturally. He states, “We now have advanced technologies that can be used to create a more youthful and well-balanced look, regardless of age.” The best part is that all these procedures can be performed simply and safely, using local anesthesia only.

We all have some level of asymmetry: This may come as a surprise but hear Dr. Kang out: “We all have some degree of asymmetry between the left and right side, which simply follows the genetic traits of our parents—even the nose and chin is half left and half right and by definition all asymmetrical.” While some patients already are aware, many need to be informed of this fact, he explains: “As we age, we lose our soft tissue cushion cloaking, aka ‘hiding,’ the inherent bony asymmetry. Gravity worsens our inherent asymmetry, as laxity of our soft tissue drape differentially from left versus right foundation of our face. As result, we all lose the inherent balance and optical symmetry of our youthful days. A smart surgeon—one who truly understand how to wind the hands of time—will gently and naturally replace the lost volume to better cloak the inherent asymmetry of bone and gently tuck up laxity of the face using well-vetted techniques.”

The chin may need special consideration: The chin is absolutely a central feature of well-balanced face, as Dr. Kang alluded to earlier. “I have always referred to chin as the base to a beautiful vase. No matter now beautiful the vase, the base provides stability and strength to the foundation of the vase. In the face, a beautiful, well-balanced face always has harmony between the nose and chin, lips and chin, cheeks and chin, and the universal triangle, or V-shape, which can be seen by drawing a line in these three structures. However, a ‘perfect’ chin should never stand out, but rather be a behinds-the-scenes feature of the face, which plays the essential role of flattering all other parts of the face. That is the best way to balance.”

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