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One of the hallmarks of youth and beauty is symmetry, i.e., one half is the mirror image of the other. When one eyebrow is up or down, when one eyelid droops and the other doesn’t, when one cheek is falling more than the other, the symmetry is marred and to our subconscious mind, the person is less attractive.Classically, aesthetic facial beauty is characterized by the ‘rule of thirds’  in which the face is divided by three horizontal lines. The top third is from the hairline to between the inside ends of the eyebrow;  the middle third is from the inside ends of the eyebrows to immediately under end of the nose; and the lower third is from immediately under the end of the nose to the tip of the chin.

Each third should be equal in vertical dimension, and each should appear equally dominant. When they are not, as demonstrated by someone with a very large forehead, large nose, or weak chin, again we subconsciously see that person as less attractive.

It’s my job as a cosmetic dermatologist to try to improve a patient’s symmetry and balance the thirds of their face.

Unfortunately, one of the things that I sometimes see are patients who either have had treatment elsewhere, are Hollywood or Reality TV stars, or just people on the street, in whom the basic rules have not been applied. You have probably seen them too. Sometimes you just know that they are “off” but not entirely sure why.

The most common of these mistakes are augmenting the lips, smile lines, and corners of the mouth, without considering the cheeks, and temples. This is especially noticeable on a thin individual with fat wasting of the cheeks and temples. They develop a “horsey” look with a prominent lower face, sunken cheeks and temples. The epitome of this look is the very diet conscious, compulsive exerciser, on Adderall and HCG, with a bunch of filler in her lips and smile lines in an attempt to compensate for her falling cheeks. Good thing that doesn’t describe me.

That’s why it is important to develop a plan with your cosmetic dermatologist, that addresses all of the areas of volume loss, to restore youthful symmetry and balance.

Then you won’t end up on TMZ as a “Don’t” with strangers commenting on your looks.

Next: Now the fine print

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