Lower-face contouring on a groom-to-be.
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Two Belkyra sessions first — deoxycholic acid targeting the submental fat pad. The fat cells don't survive it, and they don't come back. Swelling for a few days, then a permanently sharper under-chin.
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Then 4ml of Restylane Lyft. 2ml to project the chin. 2ml to define the line from the angle of the mandible through to the mentum. Firm HA, deep placement, working with the bone rather than the skin.
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Take fat away. Add structure. A profile his wedding photographer is going to love.
The brief: "I look tired."
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A common feeling — and almost always a structural story, not a sleep one. Volume loss happens in zones: temples deflate, midface cheek fat descends, tear troughs hollow, the jawline softens, the chin loses projection. The face stops looking rested, even when it is.
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She was a teaching model for a Hugel/Croma session — and the ideal candidate for a full-face reshape. 9ml of Croma Volume Plus, mapped across seven regions:
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→ 2ml temples — restoring the upper-face frame → 2ml cheeks — anterior projection → 2ml tear troughs — softening the lid–cheek transition → 1ml lips → 1ml jowl sulcus — supporting the jawline border → 1ml jawline — definition along the mandibular line → 1ml chin — forward projection
Croma Volume Plus is a firmer HA — high lift capacity, designed to sit deep against bone where structure has been lost.
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The principle: don't chase individual wrinkles. Map the face. Identify the zones that have deflated. Restore them in the right order — because cheeks read better when the temples are framed, and tear troughs settle when the cheek beneath them has projection.
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She doesn't look done. She looks rested.
The brief: "I hate the way my neck looks."
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The neck tells the truth. Thin skin, less subcutaneous support, decades of UV exposure and downward gaze — and the collagen and elastin networks underneath quietly thin out. The result is the crepe and laxity most patients first notice in their forties, and that no cream is going to meaningfully fix.
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One session with a biostimulator.
The mechanism is different to a filler. Biostimulators don't fill the lines — they prompt the fibroblasts in the dermis to lay down new collagen. The change is gradual, structural, and happens to the skin itself over the weeks following the treatment.
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Most necks need a course — usually two to three sessions spaced over several months — for the full effect. This is one session in. Already a meaningful softening of the crepe and a smoother light reflection across the area.
The principle: when the problem is at the level of the dermis, the solution has to work at the level of the dermis. You can't fill your way out of crepe. You have to rebuild it.
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Looking forward to seeing where she lands at session two.
The brief: "A milestone birthday is coming. I want to look like myself — just rested."
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This is the request I hear most often, and it's the one that takes the most planning. "Natural" isn't a single treatment. It's a sequence of small, considered changes across the right zones, in the right order — so the face still reads as hers, just on a better day.
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The plan, lower face up:
→ Belkyra x 2 — submental fat reduction. Deoxycholic acid disrupts the fat cell membrane; the body clears the rest. Permanent reduction once the cells are gone.
→ Restylane Lyft 2ml cheek — anterior projection, restoring the midface support that drops with time and pulls the lower face down with it.
→ Lyft 1ml marionette / 1ml chin / 2ml jawline — lower-face structure. Soften the marionette shadow, project the chin forward, define the line from angle to mentum.
→ Botox — frown and crow's feet. Smaller doses, kept light, so the expression still works.
→ Upper blepharoplasty — performed by a colleague, not by me. Worth naming because the eyes are doing real work in the after image, and credit belongs where credit is due.
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The principle: a natural result is a planned result. You don't get there by chasing one feature at a time. You map the face, decide what to subtract, what to support, and what to leave alone — and you respect the patient's actual face the whole way through.
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She didn't want to look 30. She wanted to look like a well-rested version of herself. That's a brief I love
The brief: "My jawline is softening. I don't want to look done."
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A patient I really enjoyed working with. A proud mum, an athlete, exercises constantly — and like a lot of lean, active women in this age bracket, the facial fat thins out faster than the rest of her. The jawline starts to soften. Early jowling appears. The face she's seen in the mirror her whole life starts to read differently in photos.
The hard part: she wanted the change without looking changed. No filler look. No pillow face. Nothing that announces itself.
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The plan was Sculptra. Two sessions, six weeks apart.
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Sculptra is a poly-L-lactic acid biostimulator. It doesn't fill — it prompts the fibroblasts in the dermis to lay down new collagen over the weeks following each treatment. The change is gradual, structural, and happens to her own tissue. By the time her family notices anything, what they notice is that she looks well — not that she looks treated.
These photos are two months after session two. A firmer jawline. Less shadow at the early jowl. The lower face holding its line again.
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The principle: when a patient says "I hate the artificial look," she's telling you what tool to reach for. HA fillers add volume — visible, immediate, sometimes obvious. Biostimulators rebuild structure from within. For the right patient, with the right anatomy, there's nothing else that reads quite as naturally.
The brief: "I want it to look like I've contoured."
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A different generation, a different ask — and one I really enjoy. She's in her twenties, she's not afraid of filler, and she came in with a clear visual reference: the sculpted, lifted, highlighted-and-contoured look she creates with makeup. She wanted the face underneath to do the work the brush usually does.
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The plan was the Art Filler range — 8ml total, mapped to the same zones a makeup artist would target with a contour palette:
→ 1ml temples — restoring the upper-face frame the contour brush usually shadows around → 2ml cheeks — anterior projection, the equivalent of a highlight on the cheekbone → 1ml piriform fossa — supporting the base of the nose, lifting the midface → 1ml chin — forward projection, the line a makeup artist creates with shadow under the lower lip → 2ml jawline — definition from angle to mentum → 1ml lips — finishing the lower-face balance
The principle: her instinct was actually a really useful brief. Makeup contouring works because it follows the same anatomical map a good injector does — light on the high points, shadow in the recesses. The difference is that filler builds the high points structurally, so the light reads off her own bone instead of off pigment.
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A clean, sculpted lower face. Defined cheekbones. A jawline that catches the light at every angle her phone camera can find. And it'll still look like her in five years — because the placement followed her bone structure, not a trend.
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A glamorous brief, executed conservatively. My favourite kind.
Non-Surgical Treatment vs. Surgery
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Is your injector honest enough to refer you for surgery BEFORE starting treatment?
The brief: "My neck is aging. I can't afford a neck lift."
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A patient I respect. She came in honestly — about her concerns and her budget — and the first thing I did was send her for a surgical consultation. Sometimes surgery genuinely is the best answer, and she deserved to hear that from a surgeon before she heard anything else from me.
A hill I'll die on: the neck is the most over-promised area in cosmetic medicine. HIFU, thread lifts, "tightening" devices — for significant neck laxity, the evidence for sustained improvement is weak. If surgery is the answer, the ethical thing is to say so.
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She came back. Surgery wasn't possible right now. She asked what I could do with the tools I have, understanding their limits. That's a different conversation — and one I was willing to have.
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The plan, over six months:
→ Sculptra x 2 — eight weeks apart. A poly-L-lactic acid biostimulator that prompts the dermis to lay down new collagen over the months following each session. It rebuilds skin thickness — it doesn't lift loose skin.
→ Fractional CO2 laser x 1 — resurfacing the epidermis and stimulating dermal remodelling. Different layer, different mechanism, pairs well with the collagen work underneath.
Six months in. Less crepe. Smoother light across the neck. Skin that's thicker, not just better-lit.
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The principle: be honest about what your tools can and can't do. She knew exactly what she was getting. I will be honest with you.
The brief: "Turning 40. I want to look softer. More feminine. Still natural — but I want to see a difference."
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This is the brief I get most often, and it's deceptively hard. Soft, feminine, natural, but visible sounds contradictory until you map it properly. Each of those words points to a specific anatomical zone — and once you know which word lives where, the plan writes itself.
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The plan, with the Juvederm range:
→ Voluma 2ml to cheeks — anterior projection. The single biggest contributor to a "softer, lifted" read. Voluma is one of the firmer HAs, designed for deep supraperiosteal placement against the malar bone.
→ Voluma 1ml to piriform fossa — supporting the base of the nose, lifting the midface, softening the early nasolabial shadow without injecting into the fold itself.
→ Ultra Plus 1ml to marionette — softening the shadow at the corners of the mouth that starts to deepen in the late thirties.
→ Ultra 1ml to lips — gentle hydration and shape, not size. Ultra is a softer HA than Plus — chosen specifically because the lip should integrate, not announce itself.
→ Botox — frown and crow's feet. Light dosing, expression preserved.
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The principle: softer and more feminine aren't achieved by adding volume to the face. They're achieved by restoring projection to the high points of the bone — cheek, piriform — so light reads off the upper midface again. The lower face is then supported, not filled.
Lips finished, not inflated. Expression kept intact.
Mathematics of beauty - the Gonzalez Ulloa Plane
The brief: "My chin sits back. Can we change it?"
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A young patient who does some modelling. A clear visual eye for her own face — and she'd noticed something most people feel but can't articulate. The chin sits behind where it should.
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This is one of the most useful planes in facial assessment: the Gonzalez-Ulloa line. A vertical drawn from the nasion (the bridge of the nose, between the brows) down through the face. For a balanced female profile, the chin should sit roughly on that line. For a male profile, slightly forward of it. When the chin sits behind the line, the lower face reads as recessive — even when every other feature is beautifully placed.
Look at the red lines. Before, the chin sits visibly behind. After, it meets the line.
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The plan: 1ml Restylane Lyft to the chin. Lyft is one of the firmer HAs in the range — designed to sit deep against bone. That's exactly what chin projection requires: structural support placed onto the periosteum, not soft tissue volume. A small volume in the right plane changes the entire profile.
The principle: assessment first, treatment second. Without the line, this is just "a bit of filler in the chin." With the line, it's a measurable, planned correction to a specific structural deficit. That's the difference between injecting and treating.
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A small volume. A meaningful change. A profile that now balances every other feature she was already born with.
Mandatories
Please ensure you have read and understood our pre-treatment protocols to ensure the best possible outcome for your cosmetic journey. Avoid alcohol consumption for 24 hours prior to your appointment.
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SCULPTRA® is a poly-L-lactic acid implant liquid that is injected by a healthcare professional into or below the skin to increase volume of depressed areas, particularly to correct skin depressions. Class III Medical Device. Sculptra® may also be used for large volume restoration and/or correction of the signs of facial fat loss. Sculptra® has risks and benefits. Sculptra® treatment may result in injection site reactions and pain. Ask your healthcare professional to explain the range of possible side effects and tell them if any side effects concern you. Sculptra® should not be injected into skin that is inflamed or infected. Exposure to excessive sunlight or UV lamp exposure should be avoided until redness or swelling has resolved. Sculptra® is not recommended for people taking blood thinning medicines and has not been tested in pregnant or breast-feeding women or those aged under 18 years. Lasts for 12-25 months. ALWAYS FOLLOW THE INSTRUCTIONS YOU ARE GIVEN. Galderma Australia, Sydney. Distributed by Healthcare Logistics Auckland.
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RESTYLANE®
ASK YOUR HEALTH CARE PROFESSIONAL IF RESTYLANE® IS RIGHT FOR YOU.
RESTYLANE® is an unfunded medicine device. Product and treatment costs apply. Restylane®, Class III medical device, is a gel containing hyaluronic acid 20 mg/mL and lidocaine 0.3%, for injection by a healthcare professional into or below the skin to smooth facial wrinkles and enhance lips. Restylane® has risks and benefits. Ask your healthcare professional if Restylane® is right for you and to explain the possible side effects. Tell them if any side effects concern you. ALWAYS FOLLOW THE INSTRUCTIONS YOU ARE GIVEN. For precautions and contraindications, see www.galdermaaesthetics.com/nz. Restylane® is a registered trademarks of Galderma Holding S.A.
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ART FILLER®
Containing low & high molecular weight hyaluronic acid, is a Class III medical device for the treatment of facial contours for redefinition, laxity and remodelling where skin laxity is a problem. ART FILLER® has risks and benefits. Do not use with treatments such a laser resurfacing or medium deep skin-peeling. Caution in people on blood thinning medicines. Do not inject into inflamed areas or intravenously or intramuscularly. Possible side effects: pain and swelling at injection site. Distributed by Cryomed Aesthetics Ltd. Auckland.
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BOTOX®
ASK YOUR HEALTH CARE PROFESSIONAL IF BOTOX® IS RIGHT FOR YOU.
BOTOX® is an unfunded medicine for aesthetic procedures so you will need to pay for the medicine and any other charges. BOTOX® is a Prescription Medicine containing 50,100 or 200 units of clostridium botulinum Type A toxin complex for injection. It is used for the treatment of frown lines, crows feet and horizontal forehead lines. It should be administered only by trained medical professionals. Cautions: people with defective neuro-muscular transmission disorders, presence of infection at site of injection, glaucoma, pregnancy and lactation. Possible side effects include headaches, pain, burning or redness at injection site, local muscle weakness including drooping eye lids, lack of feeling & nausea. Talk to your specialist about the benefits/risks of this procedure or if you have concerns or side effects. For more information, please refer to the BOTOX® Consumer Medicine Information on the MEDSAFE website http://www.medsafe.govt.nz Note: BOTOX® treatment lasts about four months and after this time further courses of treatment may be necessary. Speak to your specialist about your own situation. BOTOX® and its design are trademarks of Allergan, Inc., an AbbVie company.
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