COSMETIC MEDICINE
Volume Contouring with Profile Balancing
All appointments commence with a comprehensive consultation. During this time, we review and discuss your concerns, assess facial structure and proportions, and consider clinically appropriate non surgical treatment options. Consultations are centred on you, identifying areas of volume loss, facial asymmetry, or features that may benefit from subtle definition and contouring. A personalised treatment plan is then developed in alignment with your anatomy, goals, and clinical suitability.
Below is a curated overview designed to help you understand facial anatomy and the structural changes that commonly occur as part of the natural ageing process.
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Facial ageing is a gradual and multifactorial process involving changes to the skin, fat compartments, muscle and underlying bone structure. Over time, facial muscles lose strength and support, while deeper fat pads reduce in volume and descend.
As structural support diminishes, individuals may notice flattening of the cheeks, deepening of the nasolabial folds, hollowing through the temples, the development of jowls and reduced jawline definition. Collectively, these changes can alter facial balance and are commonly associated with visible signs of ageing.
From approximately twenty five years of age, collagen production naturally begins to decline in both men and women. In women, this reduction accelerates during the early years of menopause, with collagen levels decreasing significantly during this period. Reduced collagen impacts skin firmness, elasticity and overall structural integrity, contributing to changes in facial volume and contour.
When collagen depletion, skin laxity and redistribution of facial fat occur concurrently, the overall effect may be a gradual loss of definition and harmony, sometimes resulting in a heavier or more fatigued appearance. A thorough clinical assessment allows these structural changes to be carefully evaluated and addressed where clinically appropriate. -
Temporal hollowing can occur as part of the natural ageing process and may also be influenced by weight loss and changes in bone density. Over time, structural support in the upper face reduces, contributing to a concave or hollow appearance in the temple region.
This is often an overlooked feature of facial ageing. Volume loss in the temples can contribute to facial asymmetry and a gaunt or sunken appearance. As the area becomes more concave, it may also contribute to descent of the outer brow and a more skeletal appearance of the upper face.
Restoring structural balance in this region requires careful assessment. Makeup provides minimal improvement, and topical skincare is unable to address the deeper anatomical changes occurring beneath the skin. It is important to approach treatment holistically, as restoring volume to the mid-face without consideration of the surrounding areas, including the temples, may unintentionally accentuate imbalance.
When clinically appropriate, addressing temple hollowing can provide support to the lateral brow and enhance the peri-orbital region, contributing to improved upper facial harmony. As the outer brow naturally descends with age, structural support in this area may assist in softening a heavy or drooped appearance while maintaining natural proportions. -
Tear trough hollowing, also referred to as infraorbital hollowing or under eye hollowing, is often one of the earliest and most noticeable age related changes within the peri-orbital region. This area is particularly delicate and prone to volume loss over time.
As structural support diminishes at the junction between the lower eyelid and the upper cheek, a visible groove may develop. This hollowing can contribute to a tired, sunken or fatigued appearance, even in individuals who are otherwise well rested.
The appearance of dark circles is frequently influenced by this volume loss. Forward positioning of the orbital fat pad can cast shadows into the hollowed area, creating the appearance of darkness beneath the eyes. Thinning skin, increased pigmentation and visible underlying blood vessels may further accentuate this effect.
Genetic factors, underlying health conditions and lifestyle influences such as stress, disrupted sleep and dehydration can also contribute to the prominence of dark circles and under eye hollowing. When the tear trough region is well supported, shadowing may be reduced, the under eye area may appear brighter, and signs of fatigue can be softened, helping to restore a smoother and more refreshed appearance. -
Mid-face volume loss is one of the earliest structural changes observed in the ageing face. The cheeks play a central role in facial shape, balance and support, and even subtle changes in this area can significantly influence overall appearance.
As deeper fat pads gradually reduce in volume and underlying skeletal support diminishes, the cheek region may begin to flatten. This loss of mid-face projection can alter facial contour and may also accentuate tear trough hollowing, contributing to a more fatigued or sunken appearance. Reduced cheek volume can place increased strain on the nasolabial folds and lower face, contributing to deepening of folds, soft tissue descent and early jowl formation.
Changes within the mid-face can also affect facial proportions. As cheek projection decreases, the nose may appear more prominent, subtly altering facial harmony. Well balanced cheek structure helps maintain proportions and contribute to improved facial balance.
The cheeks function as a key structural anchor of the face. Adequate mid-face volume helps preserve facial structure by providing an anchor for the overlying skin and soft tissue, assisting in maintaining contour and minimising the visible effects of hollowing, descent and heaviness as we age. -
Subtle changes to the nose can occur over time as part of the natural ageing process, influencing both shape and projection. Although the nose itself does not lose volume in the same way as other facial structures, age related changes to the surrounding bone and soft tissue can affect its appearance.
The upper maxilla, which provides foundational support to the nasal base and tip, gradually undergoes resorption with age. As this support diminishes, the nasal tip may descend and rotate downward, contributing to a heavier or drooping appearance.
The radix, the area between the eyes where the nose begins, may also appear more prominent or deep set as surrounding soft tissue and skeletal volume reduce. These changes can exaggerate the appearance of a dorsal hump or contribute to imbalance along the nasal profile.
Alterations to nasal structure can affect overall facial harmony, particularly when viewed in side profile, where the nose plays a central role in facial proportion and continuity. A well positioned radix and adequately supported nasal tip contribute to a more balanced and refined facial profile. -
The chin and jawline play a significant role in defining the lower face and maintaining overall facial harmony. Reduced definition in this area can alter facial balance and impact how the face is perceived in both frontal and profile views.
With age, the lower face is particularly susceptible to skin laxity, soft tissue descent and changes in underlying bone structure. In women, these changes may contribute to an older or heavier appearance, while in men they can soften the lower face and reduce traditionally masculine definition. A recessed or underdeveloped chin and jawline may also be present from a younger age due to genetics, or develop gradually over time as structural support diminishes.
As skin firmness decreases and fat pads shift, the definition along the mandibular border can become less distinct. Reduced jawline clarity may draw attention to under chin fullness or imbalance within the lower third of the face.
Well defined chin and jawline structure contributes to improved lower facial proportions, enhances side profile balance and helps frame the face. Maintaining structural definition in this region supports facial harmony and can create a more refined and balanced appearance -
The lips play a central role in facial balance, expression and perceived youth. Subtle changes to the lips can significantly influence how the face is perceived, particularly in relation to vitality and expression.
With age, a combination of volume loss, repetitive muscular movement and reduced collagen production can cause the lips to appear thinner, less defined and downturned. These changes may result in a flatter or inwardly rolled appearance and can contribute to a tired or downturned expression. Reduced hydration within the lips can further accentuate fine lines and texture changes, making the lips appear dry, less supple and more aged.
Age related changes around the mouth, known as peri-oral ageing, may present as vertical rhytides, commonly referred to as smoker’s lines, marionette folds and general volume depletion. These changes occur due to repetitive muscle activity, loss of dermal collagen, declining skin elasticity and reduced moisture retention.
Lip volume and shape are also influenced by genetics, and some individuals naturally have smaller or less prominent lips from a younger age. Lip aesthetics are highly individual, and perceptions of beauty vary widely. While principles of balance and proportion guide assessment, the lips should ultimately be approached in a way that respects each person’s natural anatomy and supports overall facial harmony rather than conforming to a single aesthetic ideal. -
The neck, décolletage and earlobes have a thinner dermal structure, fewer sebaceous glands and lower collagen density compared to the face. As a result, these areas are biologically more susceptible to premature ageing and often display visible changes earlier or more prominently than other regions.
In modern, screen focused lifestyles, repetitive downward head movement can contribute to what is commonly referred to as tech neck. This may present as horizontal neck lines, early laxity of the platysma muscle and soft tissue fullness beneath the chin. Sun exposure further accelerates collagen degradation and contributes to photo damage, resulting in uneven pigmentation, reduced skin elasticity and dermal thinning across the neck and décolletage.
The earlobes are similarly affected by ageing and environmental exposure. Over time, they may become thinner, more wrinkled or elongated, often influenced by cumulative sun exposure and the long term use of heavy earrings. Changes to the earlobes can subtly affect overall facial balance, particularly when viewed in profile or when wearing jewellery.
When assessed appropriately, these areas may respond well to targeted treatments aimed at supporting skin quality, reinforcing dermal structure and improving elasticity. Addressing the neck, décolletage and ears as part of a comprehensive facial assessment helps promote long term skin integrity and overall aesthetic harmony. -
With age, the supportive structures of the mid-face, including key fat pads and underlying bone, gradually reduce in volume and shift in position. These changes play a significant role in the development of visible folds and alterations to facial contour.
As mid-face support diminishes, the cheeks may begin to descend. This descent increases tension on the overlying skin, contributing to deepening of the nasolabial folds, the lines extending from the side of the nose toward the corners of the mouth. Fine, radiating lines may also become more noticeable with facial movement, particularly when smiling.
An important anatomical area involved in this process is the piriform aperture, located at the base of the nose. Age related bone resorption in this region can create a hollowing effect, allowing adjacent fat and skin to fold forward and further accentuate creasing through the mid and lower face.
These changes may develop earlier or appear more pronounced in individuals with lean facial features, lower body fat or strong facial muscle activity. A detailed clinical assessment allows the relationship between mid-face volume loss and nasolabial fold formation to be carefully evaluated within the context of overall facial balance.
Wrinkle Reduction
All appointments commence with a comprehensive consultation. During this time, we review and discuss your concerns, assess facial movement patterns and facial anatomy, and consider clinically appropriate non surgical treatment options. Consultations are tailored to the individual, focusing on areas where repetitive muscle activity may contribute to the formation of fine lines, wrinkles or facial creases. A personalised treatment plan is developed in alignment with your facial anatomy, expression patterns, goals and clinical suitability.
Below is a curated overview designed to help you understand the facial areas most commonly affected by repeated expression and muscular movement, and how these changes may contribute to the visible signs of ageing over time.
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The forehead is one of the most expressive areas of the face. Over time, repeated movement of the frontalis muscle, which is responsible for elevating the brows, can lead to the development of horizontal lines across the upper face.
These lines often begin as dynamic, appearing only with facial expression. As skin elasticity decreases and collagen production slows, they may gradually become static and visible at rest. In some individuals, increased frontalis activity occurs as a compensatory response to brow heaviness caused by opposing muscle groups, such as the glabellar complex and orbicularis oculi. This pattern of movement can contribute to fine creases that may interfere with makeup application and create a textured appearance of the skin in both younger and more mature faces.
When clinically appropriate, treatment in this area can help soften the appearance of fine lines and wrinkles while encouraging muscle relaxation. Careful assessment and appropriate administration aim to preserve natural brow position and facial expression, maintaining a balanced and refreshed appearance rather than a frozen look. -
Frown lines are the vertical lines that develop between the eyebrows as a result of repeated facial movements such as frowning, squinting and expressions of concentration. Over time, continual activation of the muscles within the glabellar complex can cause these lines to deepen and become more noticeable.
Initially, frown lines may only appear with expression. As skin elasticity reduces and collagen production declines, they can become visible even when the face is at rest. Prominent glabellar lines may create the appearance of frustration, tension or concern, regardless of an individual’s natural expression or mood.
Overactivity in this muscle group may also contribute to muscular tension in the forehead and brow region, which some individuals associate with tension type headaches. When clinically appropriate, treatment in this area aims to soften the appearance of frown lines, reduce excessive muscle activity and support a more relaxed and approachable facial expression while maintaining natural movement. -
Crow’s feet are the fine lines that form at the outer corners of the eyes, commonly associated with repeated facial movements such as smiling, laughing and squinting. This area is particularly delicate, making it more susceptible to early signs of ageing.
These lines develop as a result of ongoing contraction of the orbicularis oculi muscle. Over time, as skin elasticity declines and structural support diminishes, crow’s feet may become more pronounced and visible at rest. While they often reflect warmth and expression, excessive line formation can contribute to a tired or weathered appearance, particularly in individuals who squint frequently or spend significant time in bright environments.
When clinically appropriate, treatment in this area may help soften the appearance of fine lines while preserving natural eye movement and expression. Careful assessment aims to maintain a balanced, refreshed look without compromising facial expressiveness. -
The position of the brows plays a key role in framing the eyes and influencing overall facial expression. Over time, repetitive muscle activity, skin laxity and age related changes to underlying support structures can contribute to gradual brow descent, particularly at the outer brow.
Activity of the superior portion of the orbicularis oculi muscle can exert a downward pull on the brows. When combined with reduced skin elasticity, this may create a heavier appearance through the upper eyelids and reduce the natural openness of the eye area.
When clinically appropriate, treatment in this region aims to soften the downward pull of brow depressor muscles, allowing the brows to rest in a more open and refreshed position. The objective is subtle elevation that maintains natural brow shape, symmetry and expression, supporting balance and harmony within the upper face. -
Bunny lines are the fine diagonal wrinkles that appear along the sides of the nose, most commonly seen when smiling, laughing or scrunching the nose. These lines develop through repeated contraction of the nasal muscles involved in facial expression.
Initially, bunny lines are dynamic and only visible with movement. Over time, as skin elasticity decreases and collagen production slows, they may become more noticeable and begin to appear at rest. In some individuals, these lines can create a creased or textured appearance across the upper nose, which may be more prominent in expressive faces.
When clinically appropriate, treatment in this area may help soften the appearance of nasal wrinkles by reducing excessive muscle activity. Careful assessment and appropriate administration aim to preserve natural facial expression while minimising unwanted creasing and maintaining overall facial balance. -
The position and movement of the nasal tip play an important role in overall facial balance, particularly during smiling and speech. In some individuals, contraction of the depressor septi nasi muscle can cause the nasal tip to pull downward when smiling, contributing to a drooping appearance.
With repeated muscle activity over time, this downward movement may become more noticeable and can accentuate age related changes to the nose. In addition, downward pull of the nasal tip may visually lengthen the nose or alter the relationship between the nose and upper lip during expression.
When clinically appropriate, treatment targeting the depressor septi nasi aims to reduce the downward pull on the nasal tip during movement. The goal is to support a more stable and refined nasal tip position while maintaining natural facial expression and harmony with surrounding features. -
Nasal flaring refers to the widening of the nostrils during facial expression, breathing or speech. This movement is primarily driven by the nasalis muscle, which plays a role in controlling nostril expansion and contraction.
In some individuals, repetitive activation of the nasalis muscle can contribute to visible flaring during expression or at rest. Over time, this movement may draw attention to the lower nose and affect overall nasal balance, particularly when smiling or speaking.
When clinically appropriate, treatment in this area may help reduce excessive nostril flaring by moderating muscle activity. Careful assessment and appropriate administration aim to soften unwanted movement while preserving natural nasal function and facial expression, supporting balance and proportion within the midface. -
A gummy smile occurs when an excessive amount of gum tissue is visible above the upper teeth during smiling. This presentation is often influenced by the activity of the levator labii superioris alaeque nasi (LLSAN) muscle, which elevates the upper lip.
In some individuals, increased contraction of this muscle causes the upper lip to lift higher than average when smiling, exposing more of the gum line. While this can be a normal anatomical variation, it may become more noticeable over time with repeated muscle activity and changes in lip support.
When clinically appropriate, treatment in this area aims to reduce excessive upper lip elevation by moderating muscle activity. The goal is to achieve a more balanced smile that maintains natural expression, lip movement and facial harmony without affecting normal function. -
A lip flip refers to subtle outward rotation of the upper lip that occurs during facial movement, influenced by the activity of the orbicularis oris muscle, which surrounds the mouth and controls lip movement.
In some individuals, contraction of this muscle causes the upper lip to roll inward when smiling or speaking, making the lips appear thinner and reducing visibility of the upper lip at rest or with expression. This effect can be more noticeable with age as collagen declines and lip support reduces.
When clinically appropriate, treatment targeting the orbicularis oris aims to reduce inward rolling of the upper lip during movement. The goal is to allow the lip to gently evert, enhancing lip visibility and shape while maintaining natural movement, speech and facial expression. -
Upper lip lines, also referred to as perioral lines, smoker’s lines or vertical lip lines, develop as a result of repeated movement of the orbicularis oris muscle, which surrounds the mouth and controls lip movement.
These lines may initially appear only with expression, such as speaking or pursing the lips. Over time, reduced collagen production, loss of skin elasticity and repetitive muscle activity can cause them to become more visible at rest. Environmental factors such as sun exposure, dehydration and genetics may further contribute to their development. Age related changes in this area may also occur alongside marionette folds, which extend from the corners of the mouth toward the chin and contribute to a downturned appearance.
When clinically appropriate, treatment in this area aims to soften the appearance of upper lip lines by moderating excessive muscle activity while preserving natural lip movement, speech and expression. -
A downward smile occurs when the corners of the mouth are pulled downward during expression or at rest. This movement is primarily influenced by the depressor anguli oris muscle, which acts to lower the corners of the mouth.
Overactivity of this muscle can contribute to a downturned or unhappy appearance, even when the individual is relaxed or neutral in expression. With age, loss of skin elasticity and structural support can further accentuate this effect, often contributing to the development of marionette folds.
When clinically appropriate, treatment targeting the depressor anguli oris aims to reduce excessive downward pull at the corners of the mouth. The goal is to support a softer, more neutral or uplifted expression while maintaining natural movement and overall facial harmony. -
A downward smile occurs when the corners of the mouth are pulled downward during expression or at rest. This movement is primarily influenced by the depressor anguli oris muscle, which acts to lower the corners of the mouth.
Overactivity of this muscle can contribute to a downturned or unhappy appearance, even when the individual is relaxed or neutral in expression. With age, loss of skin elasticity and structural support can further accentuate this effect, often contributing to the development of marionette folds.
When clinically appropriate, treatment targeting the depressor anguli oris aims to reduce excessive downward pull at the corners of the mouth. The goal is to support a softer, more neutral or uplifted expression while maintaining natural movement and overall facial harmony. -
A downward smile occurs when the corners of the mouth are pulled downward during expression or at rest. This movement is primarily influenced by the depressor anguli oris muscle, which acts to lower the corners of the mouth.
Overactivity of this muscle can contribute to a downturned or unhappy appearance, even when the individual is relaxed or neutral in expression. With age, loss of skin elasticity and structural support can further accentuate this effect, often contributing to the development of marionette folds.
When clinically appropriate, treatment targeting the depressor anguli oris aims to reduce excessive downward pull at the corners of the mouth. The goal is to support a softer, more neutral or uplifted expression while maintaining natural movement and overall facial harmony. -
A downward smile occurs when the corners of the mouth are pulled downward during expression or at rest. This movement is primarily influenced by the depressor anguli oris muscle, which acts to lower the corners of the mouth.
Overactivity of this muscle can contribute to a downturned or unhappy appearance, even when the individual is relaxed or neutral in expression. With age, loss of skin elasticity and structural support can further accentuate this effect, often contributing to the development of marionette folds.
When clinically appropriate, treatment targeting the depressor anguli oris aims to reduce excessive downward pull at the corners of the mouth. The goal is to support a softer, more neutral or uplifted expression while maintaining natural movement and overall facial harmony. -
A downward smile occurs when the corners of the mouth are pulled downward during expression or at rest. This movement is primarily influenced by the depressor anguli oris muscle, which acts to lower the corners of the mouth.
Overactivity of this muscle can contribute to a downturned or unhappy appearance, even when the individual is relaxed or neutral in expression. With age, loss of skin elasticity and structural support can further accentuate this effect, often contributing to the development of marionette folds.
When clinically appropriate, treatment targeting the depressor anguli oris aims to reduce excessive downward pull at the corners of the mouth. The goal is to support a softer, more neutral or uplifted expression while maintaining natural movement and overall facial harmony. -
A downward smile occurs when the corners of the mouth are pulled downward during expression or at rest. This movement is primarily influenced by the depressor anguli oris muscle, which acts to lower the corners of the mouth.
Overactivity of this muscle can contribute to a downturned or unhappy appearance, even when the individual is relaxed or neutral in expression. With age, loss of skin elasticity and structural support can further accentuate this effect, often contributing to the development of marionette folds.
When clinically appropriate, treatment targeting the depressor anguli oris aims to reduce excessive downward pull at the corners of the mouth. The goal is to support a softer, more neutral or uplifted expression while maintaining natural movement and overall facial harmony.
Your Consultation at The Manor Clinic
At The Manor Clinic, every appointment begins with a comprehensive consultation. Each consultation is a personalised experience, designed to understand your unique features, medical history, and treatment goals. Rather than following a standard approach, our recommendations are carefully tailored to you, guided by both clinical expertise and an artistic understanding of facial balance.
Our practitioners work collaboratively, sharing clinical insight where appropriate. This team-based approach ensures recommendations focus on safety, proportion, and outcomes tailored to your goals.
Booking a consultation reserves dedicated time with our medical team. During this time, our registered practitioner will guide you through treatment possibilities, expected outcomes, potential risks, and any downtime, allowing you to make informed decisions at your own pace. Pricing and personalised treatment plans are provided only once your suitability has been thoroughly assessed by our registered practitioner.
Following your consultation, you may choose from a considered range of clinically appropriate treatment options designed to enhance what already belongs to you. The decision to proceed always rests with you, and our role is to provide clear, accurate information and professional guidance throughout the process.
Consultation & Treatment
This appointment allows time for a comprehensive consultation as descried above, with the option to proceed to treatment during the same visit if clinically appropriate. Treatment is only performed if you feel comfortable proceeding after receiving all relevant information. Care remains guided by informed consent, clinical judgement and individual suitability.
Consultation
This appointment is suitable if you are seeking professional advice, education or a personalised treatment plan without proceeding to treatment on the same day. Consultations are available in clinic and, where appropriate, via telehealth.