Many people who come to our Fitzrovia clinic know something about their face feels slightly off, but they cannot say exactly what. They might feel they look tired, or heavier than they are, or that one side of the face does not quite match the other. Ella was one of those patients. Her treatment is a good example of how facial balancing works in practice: a plan built around the whole face, carried out in stages, with each step decided only once the last one had settled.
This case study follows Ella through four stages over six weeks, from her first consultation to her final result. It explains what was done at each point, and why.
Where Ella started
Ella came to the clinic because she felt her face looked unbalanced. There was noticeable asymmetry between the two sides, and the overall shape of her face did not look the way she felt it should. She was not asking for a dramatic change, and she was clear that she did not want to look “done”. She wanted her face to look like her own, only more in harmony.
That is a very common starting point. Patients rarely arrive asking for a specific amount of filler in a specific place. More often they describe a feeling, and the job of the consultation is to work out what is causing it.
Stage 1: the consultation
At the first appointment, Sheridan assessed Ella’s facial structure in detail. A face reads as balanced when its features sit in proportion with each other: the cheekbones, the jawline and the chin, and the upper, middle and lower thirds of the face. When one of those areas lacks support or projection, the whole face can look uneven, even if the difference is small.
Sheridan mapped out a bespoke plan focused on restoring that balance. The priority was structure. Rather than filling individual areas that looked flat or tired, the plan started with the deeper support of the mid-face, because that is what holds the rest of the face in place.
Just as important was what the plan did not do. It did not try to decide everything on day one. Sheridan agreed with Ella that the cheeks would be treated first, and that the rest of the plan would be reviewed once the result had settled.
Why the treatment was staged
Staging is one of the most useful tools in facial balancing, and it is a big part of why results look natural. There are three reasons for it.
- Features change how the others look. Restoring the cheeks alters the way the jawline and chin read. A chin that looked fine next to flat cheeks can look short once the cheeks are supported, and the reverse is also true.
- Swelling hides the true result. In the first days after filler there is usually some swelling. Judging the next step while the face is still swollen risks adding product that is not needed.
- Less product, placed well. Treating in stages means only the minimum effective amount is used at each point. That is how the face ends up looking rested rather than filled.
Stage 2: treatment day
On treatment day, dermal filler was placed precisely in Ella’s cheeks to rebuild structural support. Sheridan uses soft hyaluronic acid fillers chosen for how well they blend into the tissue, placed in small amounts, layer by layer. Numbing cream is applied first, and most fillers also contain a local anaesthetic, so the treatment is more comfortable than many patients expect. You can read more about this part of the treatment on our cheek fillers page.
Ella also had a chemical peel at the same visit to refresh the quality of her skin. Filler and skin treatments work well together: one restores the shape of the face, the other improves the surface light reflects from.
Straight after the appointment, Ella’s face already looked noticeably lifted and balanced, with a softer, more oval shape. There was some mild swelling, which is completely normal in the first few days.
Stage 3: two weeks later
By the two-week review, the swelling from the cheek filler had fully settled. Ella’s features looked softer and more harmonious, and the asymmetry that had bothered her was much less noticeable.
This is where staging proved its value. With the mid-face now supported, it was clear that the lower third of Ella’s face, around the jaw and chin, was short in comparison. Before the cheeks were treated, that was much harder to see. Sheridan recommended slightly extending the chin to bring the lower face into proportion with the rest.
Had the chin been treated on the first day, it would have been a guess. At two weeks, with a settled face to assess, it was a clear decision.
Stage 4: the chin, and the final result
A small amount of filler was placed to extend Ella’s chin slightly. Chin filler can change the balance of the whole face, lengthening the lower third and giving the jawline a cleaner line, so a little product makes a real difference. Our chin augmentation page explains the treatment in more detail.
The result, straight after the chin filler, was a face that looked lifted, balanced and completely natural. That is the outcome facial balancing aims for. People around Ella could see she looked well, but no one could quite place what had changed.
What Ella did not need
Ella’s plan is as much about restraint as about treatment. She did not have filler chasing every line or hollow, and she did not have volume added to areas that were already in proportion. The whole result came from two areas: support in the cheeks and a little more length in the chin.
This reflects Sheridan’s approach to every face: structure first, lines second. When the deeper support is restored, many of the things patients notice on the surface soften by themselves, and far less product is needed overall. If filler is not the right answer for a patient, Sheridan will say so at the consultation.
Looking after your results between stages
Some swelling or bruising is normal for a few days after each stage. To help the result settle well:
- avoid touching the treated areas, and do not wear make-up, for 4 hours
- avoid alcohol and strenuous exercise for 24 hours
- avoid heat, such as saunas, hot drinks and direct sun, for 72 hours.
Our dermal filler aftercare guide covers this in more detail. If you have a wedding or big event coming up, allow at least two to four weeks before it, so any swelling has settled and any follow-up can be done in time.
What Ella’s case means if you are considering facial balancing
- Expect a plan, not a single appointment. The best results often come from treating one area, reviewing, then deciding the next step.
- The cause is not always where you notice it. Ella’s concern was asymmetry, but the answer involved both her cheeks and her chin.
- Less is usually more. A small amount of product in the right place does more than a large amount spread across the face.
- Your plan will be your own. Every face is different, so your treatment may look nothing like Ella’s.
For an overview of the approach, read our guide to facial rebalancing in London.
Frequently asked questions
Why not treat the cheeks and chin on the same day?
Because treating the cheeks changes how the chin looks. Waiting until the cheeks have settled, at around two weeks, shows whether the chin needs anything at all, and how much.
How long did Ella’s treatment take in total?
Four stages over about six weeks, from the first consultation to the final result.
How long do facial balancing results last?
Typically 12 to 18 months, depending on the products used, the areas treated and your own metabolism.
Does it hurt?
Numbing cream is applied before treatment and most fillers contain a local anaesthetic. Most patients find it more comfortable than they expected.
Can I find out if I am suitable before booking?
Yes. You can send a few photos of your face for a free, no-obligation assessment, and Sheridan will tell you whether facial balancing is right for you before you come in.
Every patient is different. Results vary depending on anatomy, lifestyle and aftercare, and this case reflects one patient’s experience rather than a guaranteed outcome. All dermal filler treatments at Sheridan France are carried out by an NMC-registered Aesthetic Nurse Practitioner and Independent Nurse Prescriber, only after a consultation.
To find out whether facial balancing is right for you, call 0207 631 5001 or read more about our facial balancing treatment in London. Our clinic is at 4 Windmill Street, Fitzrovia, London W1T 2HZ.
