Facial Harmonization in Uberlândia, Brazil

Hyaluronic acid is a substance the body produces on its own: it is present in the skin and tissues, where it retains water and provides support. In fillers it is manufactured as a gel, registered with Anvisa, the Brazilian health surveillance agency, in different densities according to the region being treated. It is gradually absorbed by the body — which is why the effect is temporary rather than permanent.

Botulinum toxin acts on the muscle, temporarily reducing the contraction that creates expression lines. Hyaluronic acid filler restores volume and support where it has been lost, addressing contour and proportion. They act differently and are frequently complementary within the same plan.

Not necessarily — it may involve botulinum toxin, technologies and other techniques, per individual assessment.

It is generally quick, with a return to regular activities often possible within a short time, though some redness, swelling, or minor bruising can occur in the first few days.

The plan is defined case by case and may combine filler, botulinum toxin and technologies; what follows describes the filler step. Hyaluronic acid gel is usually not placed inside the line or fold that bothers the patient: in most cases it is deposited at the face's support points — the malar and zygomatic region, the chin and the jaw angle — in a deep plane, against bone. The rationale is anatomical: the facial skeleton resorbs over time and the deep fat compartments resting on it lose volume, and an anatomical study of 40 cadaveric specimens using CT and MRI found no downward displacement of material placed in the deep midface compartments — which does not rule out migration, described in the answer on what can go wrong. A needle is used for deposits on bone and a blunt-tip cannula for subcutaneous passes, with small volumes per region. Instrument, plane and volume follow vascular-safety criteria and are decided case by case — no single maneuver removes the risk of vascular occlusion. A session usually takes 15 to 45 minutes depending on how many regions are treated, with reassessment 2 to 4 weeks later.

No. The hyaluronic acid in a cream and the one in a filler are not the same thing and do not reach the same place. Topical hyaluronic acid stays at the skin surface, where it holds water and improves hydration and immediate appearance. A filler is a cross-linked gel, registered with Anvisa — the Brazilian health surveillance agency — as a medical device, placed under the skin or on bone through a needle or a cannula. A cream does not restore volume, does not change contour and does not reach the deep compartments. Home recipes and protocols sold as needle-free alternatives have no support in the literature, and when they involve an injectable product of unknown origin they add the risk of infection and of inflammatory reaction with no predictable way to manage it.

No — filler is additive, and in absolute volume the nose becomes slightly larger. A dorsal hump is not reduced, it is camouflaged: the radix — the root of the nose, between the eyes — above it and/or the supratip just below it are filled so that the dorsal line reads as straight. The tip can also be projected and small contour irregularities corrected. What does not change: the width of the bony dorsum, the alar base, a bulbous tip and significant structural deviation, all of which belong to rhinoplasty. This is not rhinoplasty, does not replace rhinoplasty and does not produce an equivalent result. There is no functional benefit: filler does not treat obstruction and does not improve breathing, and a breathing complaint needs its own specific assessment. Conversely, a change in breathing that appears after an injection should be reported — internal nasal valve collapse has been described after filler in this region. In a previously operated nose the adverse event rate is higher, and the nose is the region of highest vascular risk on the face.

They are different things and not interchangeable. An anatomical study using CT and MRI in 40 specimens found no downward displacement of material placed in the deep midface compartments, and described support for the structures above it — that is the basis for treating the support points — the malar and zygomatic region, the chin and the jaw angle — rather than the fold. That basis, however, comes from cadaver and imaging work, not from a clinical trial demonstrating elevation of tissue that has already descended: there is no evidence that filler replaces surgery where laxity is significant. There is also a quantitative limit, measured in a separate study of four specimens: the surface-to-volume coefficient of the deep medial cheek fat is 0.29, the lowest of the five compartments assessed — each milliliter there changes the surface very little, and chasing transformation in that region leads to over-filling. When laxity is the main complaint, filler is not the tool.

It varies depending on the combined techniques and the goals defined during the consultation — it may be a single session or a plan with follow-up sessions over time.

Yes, it's common to combine filler, botulinum toxin, and other technologies in the same visit, based on an individual plan.

Discomfort is usually mild and is minimized with topical anesthetic or local blocks, depending on the technique used.

During the session a topical anesthetic is used and, when indicated, local blocks, and most hyaluronic acid gels already contain anesthetic. Afterwards, what patients describe is less pain than tenderness to touch and a feeling of weight or pressure in the treated areas, most noticeable over the deep deposits on bone — chin, jaw angle and malar region — and in the first 48 hours. Palpable lumps in the first days, with nothing visible, are common and tend to settle. Pain that increases instead of easing, pain out of proportion during the injection itself, pallor of the skin, a net-like mottling, any change in vision, weakness on one side of the body, difficulty speaking or a sudden severe headache are not part of the expected course and should be reported to the team immediately.

Guidance such as avoiding direct sun exposure, intense exercise, or touching the treated area is typically given based on the technique performed.

Yes, these are possible and generally temporary reactions; more specific concerns should be discussed at the consultation based on the patient's history.

Swelling is usually greatest in the first 24 to 48 hours and subsides over the first week in most regions; in the chin, along the jawline and around the eyes it can take around two weeks to settle. Worth noting: early swelling overstates the result, so what you see the next day is more than the settled outcome — which is why reassessment is done 2 to 4 weeks later rather than sooner. For the first nights patients are generally advised to sleep on their back with the head slightly raised, so as not to press on the treated areas. No rest period is needed and usual activities resume the same day, avoiding intense exercise, heat and handling the area in the first days.

There is no incision and no suture: access is through fine needle punctures or a single entry point for the cannula, which usually leaves no perceptible scar — what may appear is a small red dot or a bruise, generally temporary. As for acne scarring: filler at the support points does not treat skin — it does not change texture, pores, pigmentation, fine lines or skin laxity, and it is not an approach to diffuse acne scarring. Isolated deep scar depressions can, in selected cases, be addressed by other techniques, assessed individually. An area with significant scar change or previous radiotherapy calls for particular caution in the indication.

An artificial look usually comes from excessive volume, from product placed in the wrong plane or region, or from repeated sessions without an interval to assess the previous result. That is why planning here is gradual: what is needed is applied, the result is reassessed, and only then is any complementary step decided. Hyaluronic acid fillers have the further advantage of being absorbable and, in many cases, removable with a specific enzyme when necessary — something permanent products do not allow.

Excess volume is the most cited cause of regret and is covered in another question on this page. Beyond it, the literature describes adverse outcomes specific to filler: distorted contour at rest and unnatural movement, now described as an entity of its own; irregularity and palpable nodules from superficial placement; product migration; persistent malar swelling; and asymmetry. And there are late inflammatory nodules and reactions, from weeks to months afterwards: a multinational consensus attributes them to an interaction between product, bacteria and immune response, with described triggers including systemic infection, dental procedures and vaccination — which is why an interval between those and the session is advised.

The most serious risk is vascular occlusion: gel injected into a vessel, or compressing one, can cause skin ischemia, necrosis and — through retrograde embolization to the ophthalmic artery or to the cerebral circulation — vision loss and stroke. It is rare and it is well documented. A 2024 review gathering the 365 cases of vision loss reported in roughly a century of world literature points to the nose (40.6%), the forehead (27.7%) and the glabella (19.0%) as the regions most often implicated; 19.2% of those cases had strokelike features and, among cases with a reported outcome, 68.2% recovered no vision. In the published series the chin and jaw angle appear far less often than the middle and upper thirds of the face — which is not the same as being free of risk: the region has vessels of relevant caliber, the mental nerve runs close to the injection points, and vascular occlusion has been reported around 24 hours after a low-volume chin injection. The warning signs apply to every treated region. That is why the procedure requires an established vascular occlusion protocol, which includes breaking down the hyaluronic acid with a specific enzyme — a requirement, not a selling point. In March 2026 Anvisa, the Brazilian health surveillance agency, issued a safety notice recommending that dermal fillers be used only in the regions and volumes set out in each product's instructions for use.

The oculoplastic literature describes the infraorbital region as unforgiving, and the numbers explain why. In a retrospective series of 447 patients and 706 infraorbital treatments, swelling in the first two weeks occurred in 51% of the injections given with hyaluronic acid alone — 103 of 202 — and its frequency tracked the volume injected: 37% up to 0.55 mL, 51% between 0.56 and 1 mL, and 60% above 1 mL. Eyelid skin is thin: any bleeding shows, and gel placed superficially can produce a grayish or bluish discoloration. There are reports of malar edema lasting years, and a series in which mild swelling persisted in some patients even after the product had been dissolved with the specific enzyme. There is also a formal point: Anvisa recommends that each filler be used only in the regions and volumes set out in its own instructions for use, and not every product available in Brazil covers the periocular area — here the choice of product follows the instructions for use of the material used, and the decision is made at the consultation. The indication is therefore discussed carefully, and deciding against it is a possible outcome.

The goal is always naturalness — planning aims to reinforce the patient's features, not standardize them.

It varies by technique used — some have a temporary effect, others are longer-lasting.

It depends on the technique — some effects are noticeable right after the procedure, while others develop gradually over the following weeks.

The gel is placed on bone at the pogonion — the point of the chin — and at the jaw angle, which tends to give the chin anterior projection and to define the jawline in profile. What it does not do: it does not slim a square face, because filling the jaw angle widens the lower face rather than narrowing it; it does not remove a double chin or an established jowl along the jawline; and it does not correct true skeletal disproportion — when the chin is markedly set back for skeletal reasons, the assessment points toward a surgical approach, not filler. The magnitude is modest: a 12-month observational study measured a mean gain of 1.83 degrees in the facial angle. Swelling here can take around two weeks to settle, and the literature favors splitting volume across sessions rather than accumulating it in one.

It addresses part of the problem, and only in some patients. Dark circles are not one single thing: the clinical classification separates a pigmented type, a vascular type, a structural type — the shadow cast by a real depression between eyelid and cheek — and a mixed type. In a series of 65 patients the mixed type accounted for 78% of cases and the purely structural type for only 3%. Filler acts on the structural component alone: by softening the step at the orbital rim it tends to reduce the shadow. It does not lighten pigment, does not erase the vascular network seen through thin skin, does not reduce a protruding fat pad and does not correct excess eyelid skin — those causes call for a different assessment. Where there is a protruding pad with very thin skin, adding product tends to make the appearance worse.

Erase them, no. The nasolabial fold — the line running from the nose to the corner of the mouth — is not a wrinkle: it is an anatomical border present at every age, including in children, formed because fibers of the lip elevator muscles insert directly into the skin along that line. That attachment is what allows you to smile, which is why the fold neither disappears nor should. What changes over time is how deep it looks, because a deep fat compartment above the maxilla loses volume and the bone itself recedes. When that is the cause, restoring volume in the malar region tends to soften the fold without injecting into it. Choosing between treating the malar support and treating the fold itself is an individual decision, and depends on which component predominates on examination. The component that appears only when you smile barely changes.

No. Hyaluronic acid gel occupies space and has no lipolytic action — it does not dissolve, burn or remove fat; botulinum toxin acts on muscle and does not act on fat either. What filler can do for a double chin is indirect: projecting the chin and redefining the jaw border, the angle between chin and neck tends to close and a more defined contour may come to separate face from neck, so that the same amount of fat tends to read as less obvious. That is contour camouflage, not volume reduction. It does not change skin laxity, platysmal bands or the position of the hyoid bone, which is a fixed limit. In a bulky double chin, adding volume to the lower third tends to add weight. Submental fullness that on examination is not fat has to be clarified before any aesthetic procedure.

Hyaluronic acid is absorbable and, in many cases, can be broken down by hyaluronidase, an enzyme injected into the area — something permanent fillers such as methacrylate and liquid silicone do not allow. That is not, however, a complete safety net. The available scoping review records that no randomized trial defines the enzyme's dose and protocol for the face; the enzyme itself can cause an allergic reaction; there is a series in which mild swelling persisted after the product was no longer visible or palpable; and in the chin a CT study of 80 patients described local bone resorption after filler, with a worse outcome in those who received 1 mL or more per session, in patients without symptoms — a retrospective, single-center finding, not a settled one. There is a way to reverse; there is no guarantee that every consequence is undone.

Yes. Planning is individual and takes male facial proportions into account, which are different: generally the aim is to preserve or reinforce features such as the jaw angle and chin projection rather than soften them. The goal remains naturalness.

Pregnant or breastfeeding patients and those with active infections in the treated area are generally not eligible; an individual evaluation during the consultation determines feasibility case by case.

These are two separate discussions. The term orofacial harmonization designates a field created for dentistry by Resolution 198/2019 of the Brazilian Federal Council of Dentistry; in an action brought by medical bodies, the 8th Panel of the Federal Regional Court of the 1st Region decided by majority, in August 2026, to annul that resolution — a decision still open to appeal, which the Council of Dentistry has said it will file. The Federal Council of Medicine holds that cutaneous filler is a medical act. The dispute is ongoing and this site is not the place to settle it. What can be stated is what applies here: the procedure is performed by Dr. Lorena Gidrão de Queiroz, physician and plastic surgeon — CRM-MG 85769, RQE 71258. It is also worth noting that facial harmonization is neither a specialty nor a recognized area of practice at the Federal Council of Medicine: it is a set of procedures carried out within a specialty.

Duration varies with the region treated, the density of the product and each person's metabolism; broadly, from a few months to around two years. Regions with a lot of movement tend to absorb the product faster than regions that provide structural support. The expected duration for each case is discussed at the consultation.

For most techniques, yes, since effects tend to be temporary; the maintenance schedule is discussed individually during the consultation.

Reassessment 2 to 4 weeks after the session is part of the plan, not a sign that something went wrong: with the swelling gone it becomes clear whether any region needs a complement. At the midface support points — the malar and zygomatic region — the usual expectation is around 12 to 24 months, with gradual rather than abrupt loss. The chin and jaw angle tend to resorb faster, because of local muscle activity: they are support points, but they sit in a region of considerable movement, and that is the variable that governs duration, following the same logic set out elsewhere on this page. The available figures are indirect measures: in a jawline study followed by 3D scanning the measured effect declined steadily over 12 months, and in an 18-month chin trial the effect was still present but well below what it had been a month after injection. As the product is absorbed, the contour tends to return gradually to what it was, plus the aging that occurred in the meantime. The idea that a face collapses because it was once filled has no support in the literature — which is not the same as saying there is no consequence at all: local bone resorption in the chin and residual swelling are described findings, set out in the answer on reversal. Maintenance is decided at each reassessment, never on a fixed calendar.

Care is private — Dr. Lorena does not work through health insurance. In addition, procedures performed for aesthetic purposes fall outside the mandatory coverage of Brazilian health plans by law.

No — the SUS does not cover procedures performed for purely aesthetic purposes. Dr. Lorena is a plastic surgeon appointed by public examination to the Hospital de Clínicas of the Federal University of Uberlândia (HC-UFU) and preceptor of its plastic surgery residency, and she operates on SUS patients there, for reconstructive and functional indications. For those, the route is for the patient to register at the primary care unit (Unidade Básica de Saúde) nearest to her home, be assessed by a doctor there and, if there is an indication, be placed in the regulation queue of her municipality. The surgeon cannot choose who is operated on through the SUS — the order follows the queue and the rules of the system strictly.

We do not publish isolated before-and-after pairs. Resolution 2,336/2023 of the Brazilian Federal Council of Medicine allows results to be demonstrated, but only within a set that also includes unsatisfactory outcomes and the complications described in the literature, across different body types, age ranges and stages of healing, and with no editing of the images (art. 14, II). An isolated pair of photos does not meet those requirements and also implies a guaranteed result, which the same resolution prohibits (art. 11, XII). At the consultation the expected outcome is discussed from your own anatomy — what is reasonable to expect, what is not possible, and what the risks are.