Dr Tim Pearce
As clinicians treating patients or patients seeking to be more beautiful, the first thing we need to understand is bone structure. The bones or skeleton are the underlying structure of our face on top of which all other structures sit. They really are the foundation of beauty, yet not many people talk about what it is about bone structure that makes people attractive in a way that can be used practically in clinic.
Many injectors first realize they need to understand bone structure when they begin treating cheeks, chins, or jawlines. While trainers often focus on safety, depth, and position, the aesthetic understanding of what we’re trying to create with every injection is equally crucial. How do we know when we need to inject, when it’s too much, and when it’s just right?
One valuable way to understand facial structure is through sculpting – an exercise recommended for all clinicians to try at least once. When you attempt to sculpt a clay model using what you think you understand, you quickly see the gap between your current knowledge and what there is still to learn.
While proportion is useful, it isn’t what the structure of the face is truly made of. We need to understand something at a higher level than simply the golden ratio. What is the ratio between? It’s these points, planes, and lines that form the three-dimensional shape of your face that become useful for everyday injectors.
On facial models, we can observe the planes of the face, which ultimately are what our eye sees. Our eye really sees the combination of light and shade caused by these planes reflecting a pattern that our brains turn into something that means “human.” Our brains are primed to make meaning out of that, looking for:
This is ultimately what aesthetics is really about – what humans find attractive. It’s about:
The strongest evidence for the golden ratio’s usefulness can be seen in facial proportions:
These ratios appear across different races and nationalities, making them incredibly useful for clinical decisions.
While ratios are helpful for drawing static images, creating three-dimensional beauty requires understanding:
Recent viral social media content has highlighted the importance of strong chins. A well-defined chin creates what can be seen as the base of the presentation box of the eyes – the lowest structure that makes everything else look part of that structure seamlessly.
However, there’s a crucial warning: chins can become too strong and masculinizing. This is a key consideration when using dermal fillers for chin enhancement. Everything done to make chins bigger risks making them more masculine, which may or may not be the goal.
Although strong chins are important for both male and female beauty:
While textbooks often say the chin should project no further than the bridge of the nose, many A-list celebrities break this ratio. Strong chins that project beyond the Ian can be more beautiful in many people – more striking or statuesque rather than babyface beauty.
When treating patients:
Understanding bone structure is fundamental to creating beautiful results in aesthetic medicine. It’s not just about knowing where to inject – it’s about comprehending the underlying framework that defines facial beauty. This knowledge allows us to make better clinical decisions and achieve more natural, harmonious outcomes for our patients.
Remember: the goal isn’t always to change everything we see. Sometimes the best treatment plan involves working with existing bone structure rather than against it, enhancing natural beauty while maintaining appropriate gender characteristics and facial harmony.
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Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.
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