A full facial rejuvenation by Nina Bal

Nina Bal uses dermal fillers and botulinum toxin in a full facial rejuvenation to create a more youthful appearance for this mid-40s female patient.

The female client, in her mid-40s, attended the clinic on the recommendation of a friend. She felt that the ageing process was catching up with her, that she looked tired and didn’t like her face shape and side profile. She had noticed that her lips had thinned.

The patient is medically well, doesn’t smoke and has a healthy lifestyle. She works full-time as a manager in property in central London – a job she describes as highly stressful. The patient is also about to graduate in naturopathy, a subject that she studies every evening, and has around four to five hours’ sleep, at most, per night. She is 44 years old and is single with no children.

Clinical examination

A full clinical examination and photographic record were carried out. The patient was examined extraorally and presented with a class II skeletal base, a shorter lower third face-height compared to the upper and mid-face and a retrognathic chin.

The face was assessed when animated (while frowning, raising the eyebrows and smiling) and when at rest. She presented an increased tear trough (dark circles), lips were competent and her face shape is square. The patient had previously received botulinum toxin treatment to the upper third of her face, and a hyaluronic acid (HA) filler injected into her cheekbones. She wanted to achieve a natural rejuvenation of her face with minimal downtime due to her job.

The clinician identified subtle volume change in the forehead, eyebrow, under the eyes, malar, lips, and jawline that were contributing to early signs of facial ageing.

Before Treatment

Diagnosis and treatment options


It was recorded that the patient…

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