Quiet beauty: what it is and why overdone facial harmonization went out of style

What is quiet beauty

Quiet beauty is a concept that has gained prominence in the aesthetics market, and it is about a natural look: enhancing the features that make a person beautiful, without drastically changing each individual's structure and anatomy. Instead of following a standard face, treatment starts from the face that already exists.

I saw this concept in the spotlight at MAAC, a congress on injectables and aesthetics. It makes a lot of sense in my clinical practice, because it aligns with the way I already work in my office. The trend is a return to a natural look, a shift we had already seen coming.

Why the overdone look went out of style

For a few years, facial harmonization was associated with large volumes, injected all at once, and with the same design applied to very different faces. High, full cheekbones, a projected chin, voluminous lips, and a defined jawline, on anyone. The result was predictable: with all the excesses and exaggerations, everyone started to look the same.

This standardization brought back the desire for a natural look. What people want now is to look rested, younger, or more harmonious, without anyone being able to point out what was done. It is what I call aging quietly.

What medicine says about excess

Overdoing it also has a medical explanation. The literature already describes what is called overfilled face syndrome, also known as pillow face: a face that looks puffy and stiff, without the natural lines of expression and with altered proportions.

Recent reviews point to causes that help explain the problem:

• Accumulated injections. When part of the filler is reabsorbed, some people get new injections one after another, and the new product adds to what was still in the tissue.
• Volume beyond what the tissue can hold. Each area can take a certain amount of product, and going past that limit distorts the contour.
• Focusing on details and losing sight of the whole. Filling an isolated area without looking at the harmony of the entire face.

There is also a finding that changed the way many physicians think about filler: hyaluronic acid can last longer than was once thought. In a report published in 2022, MRI scans still showed the gel in lateral and deep areas of the face 27 months after injection, while in the chin it had almost completely broken down by 19 months. The authors observed that duration seems to depend on the area, the depth, and the amount injected.

The practical conclusion is simple. Adding more product at every session, without considering what is still in the face, is the shortest path to excess. The reviews recommend the less-is-more principle and advise against large volumes in a single session.

Volume only where it is lacking

In my practice, I am not a fan of sessions with 10, 15, or 20 ml. We always work within the patient's budget, and we will never inject 15 or 20 ml at once. I prefer to work with subtlety and add volume only where there is a real deficit.

An example helps illustrate this. With aging, a small pocket of fat can form along the jawline, which we call a jowl. To soften it, there are different approaches: dissolving that fat, repositioning the tissue with tension threads, or having a surgical facelift. When the patient prefers something minimally invasive, one option is to fill the surrounding area, which has lost structure. In one case I shared, I used 1 ml per side. It is a small volume, and it was enough to improve the contour without making the patient look artificial.

Each case is evaluated individually, and the right amount for one person may be very different from the right amount for another. The amount is a result of the analysis, never a package decided before looking at the face.

Facial analysis comes first

Before proposing any filler, it is necessary to understand how the eyes, nose, chin, eyebrows, and jaw balance one another. During the analysis, I look at the thirds of the face, the proportions, and each patient's particular features, at rest and in motion.

Sometimes the analysis shows that what makes the biggest difference is in an area the patient had not even thought about. In one case, treating only the chin was enough to balance the proportions of the entire face. In others, it shows that not every lip needs volume and not every asymmetry needs to be corrected. Small differences are part of a face's identity.

The reviews on overfilling reach the same recommendation: carefully assess the bone structure, the distribution of the tissues, and the elasticity of the skin before any injection, with a personalized plan for each patient.

Beleza de Precisão in practice

Beleza de Precisão is the technique I developed from this way of looking at the face. It starts from quiet beauty and goes one step further: millimetric adjustments, planned based on facial analysis, to enhance your beauty without changing your natural features. The goal is to reach your best version and still recognize yourself in the mirror.

In practice, this means a few clear choices:

• treating the face as a whole, not area by area;
• using the smallest amount of product that can address the concern;
• preserving the features that make each face unique;
• following the patient over time, because beauty is a long-term relationship.

No procedure is free of risk. Swelling, bruising, tenderness, and temporary asymmetry can occur after any filler treatment, and results vary from person to person. When necessary, hyaluronic acid can be dissolved with hyaluronidase. That is why the first step is always the consultation.

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