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How to... enhance your bone structure with aesthetic treatments

How practitioners can sculpt and shape your face to emphasise your natural features

Due to almost a year in lockdown, most of us have been spending more time on Zoom, Google Hangouts and FaceTime than ever before.

Not only do these platforms distort our idea of our own faces – flat screens tend to emphasise drooping and sagginess, while looking downwards into a camera is generally unflattering – they have also given us countless hours to scrutinise our own faces.

No wonder then that, when it comes to post-lockdown wish-lists, facial sculpting is right up there alongside a proper night out with friends and finally getting our highlights freshened up.

"The phenomenon of 'lockdown face' has led to a surge of interest in medical aesthetics, as more and more people discover the beautiful and subtle tweaks that can be accomplished,” agrees EV expert Dr Emmaline Ashley. “When it comes to facial sculpting this is very much a bespoke treatment that can enhance your natural features.”

What exactly is facial sculpting? 

Facial sculpting is the name given to a set of treatments which aim to bring your features into proportion. It’s bespoke, so every consultation with a practitioner and set of treatments or singular treatment recommended will be different, depending on what you want and need.

“Facial sculpting works to balance and bring our features into proportion, using subtle and natural enhancements that leave you still looking like yourself, but even more beautiful and refreshed,” Dr Ashley explains.

Practitioners usually begin with an extensive consultation, where your needs and concerns are addressed. They then use what’s termed The Golden Ratio to assess your face.

“A lot of beauty is subjective and influenced by time, place and culture,” says Dr Ashley. “However, there are certain proportions of facial features that are typically deemed universally pleasing. The Golden Ratio is often used by aesthetic doctors to help balance features. It's a proportion that exists already in many places in nature – for example, the spiral of a sunflower’s seeds or the curl of a shell.

“When assessing a face we start by examining the foundation ratio, which is the intercanthal distance or the distance between your eyes,” Dr Ashley continues. “This is constant and will not change throughout your life. This distance should be the same as the width of your nose, the length of each eye, and the width of the chin in women.”

By understanding this ratio, an aesthetic doctor can start to assess where they may want to add volume to features with filler, as well as understand when not to add volume as that would push features out of proportion.

Why is bone structure so important? 

When it comes to our facial features, how we look is very much determined by the bones of the face. “Our bone structure is the scaffolding on which everything else hangs, so it's very important to the overall construction of our face and appearance,” says Dr Ashley.

“The focus in a lot of facial aesthetics is about balancing proportions and also maintaining what we have in our youth, so it’s important to understand what happens to the face as we age,” she continues.

“The loss of volume is key. Dermal fillers are used to strategically add volume, so in the ageing of the face the two aspects to look at are the way the bone reabsorbs as we age, as well as the change in the fat pads on our faces.”
With facial sculpting, often filler is applied directly to the bone, restoring ideal structure and symmetry.

As we age our bones also naturally become thinner. “Three areas that are particularly affected are the mid-face, around the eye socket, and the jawline,” says Dr Ashley.  “This leads to loss of volume and flattening in the cheeks, deepening of nasolabial folds, and the loss of a sharp jawline and development of jowls, which often brings patients into clinic.”


Dr Ashley explains that cheekbones are often the first priority for patients when it comes to facial sculpting.

“Volume loss to the mid-face, when corrected, can have a knock-on effect for so much else,” she says. “With the cheeks we are mainly looking at the zygomatic bone and treatments in this area are often delivered as boluses onto the periosteum of this area. This can actually be an incredible treatment for the face structure overall, as restoring youthful volume can have the effect of both lifting anything that is sagging below around the jawline (as in jowls), as well as supporting everything above (hollowing around the eyes).”

Who’s it for? 
Anyone worrying about volume loss, especially women in their late 30’s and 40’s, because it can give a subtle lift and enhancement that rejuvenates your whole face.


The upper and inner section of the eye socket is often reabsorbed with age, and this can contribute to a drooping appearance of the outer brow.  
 “The best way to address this is with a non-surgical brow lift, which can be performed with botulinum toxin,” Dr Ashley suggests. “Expertly-placed injections can relax the muscles that pull the brow down, allowing the elevator muscles to subtly lift and open this area.”

Another option is carefully placed filler in the temple, to correct the hollowing and concavity that can occur. This gives a fuller and more youthful look.

Who’s it for?
This is an excellent option for patients in their 30s, 40s or 50s to create that subtle lift to the brow.


We lose jaw length and height as we age, as well as suffering from hypertrophy of the fat pads in the area. This can lead to the formation of jowls.

“Adding volume to the angle of the jaw as well as at the pre-jowl sulcus can help restore the jawline, as well as lifting any sagging skin around that area,” says Dr Ashley.

“In both men and women the length and height of the mandible (lower jaw bone) decreases with age, which contributes to the loss of a defined jawline. To correct this, injections of filler can be added to the angle of the jaw to lift and provide structure, as well as to the chin and the pre-jowl sulcus,” she explains.

Another option is to inject botulinum toxin into the masseter muscles to help slim the face and bring the jawline back into proportion.

Who’s it for?
This is a very popular treatment for male patients in their 40s and older, to help maintain a chiselled jawline and strong chin. Botulinum toxin treatment to slim the jawline is a popular treatment in women starting from their 30s,” Dr Ashley states.

What to ask your doctor

Treatments should always be guided by your specific needs – don’t feel afraid to ask your doctor to explain why a treatment will address your concerns.

Ask what products will be used in each area, and make sure they have explained what can realistically be achieved, and how long the results will last.

Emmaline Ashley, Aesthetic Doctor

I'm Dr Emmaline Ashley, the founder of Ashley Aesthetics. I'm passionate about beauty, wellness and science. I wanted...

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