Dr Ewa Kania

A softer jawline doesn’t automatically mean you need more volume.

Sometimes I look at a patient and the volume is actually quite good. What’s changed is the support of the tissue and there’s some early laxity, particularly through the lower face.

That’s where I might think about HIFU. We’re not adding anything to the face; we’re using focused ultrasound to stimulate a gradual tightening and remodelling response.

The important part is working out whether what you’re seeing is volume loss, laxity, or usually a little bit of both. They can look very similar, but I wouldn’t necessarily treat them in the same way.

When patients tell me they want some volume back but don’t want to look filled, I completely understand what they mean.

Sometimes filler is appropriate, but sometimes I’m more interested in improving the tissue itself. That’s where collagen stimulators become really useful. We’re encouraging your own collagen production gradually, so the change happens over time rather than overnight.

For me, it’s less about adding volume and more about restoring some of the support the face has lost. The aim is that you look fresher and healthier, without it being obvious why.

The prescription is actually the straightforward part.
What interests me is everything happening around it. How quickly are you losing? Are you losing muscle as well as fat? Are you eating enough protein? Are you strength training? What’s happening to your skin? And how is your face changing? That’s why I prefer to have these conversations at the beginning. It gives us the opportunity to protect what we can rather than waiting six months and asking how we rebuild it.

“I’m not particularly fond of the term “GLP-1 face”. It makes it sound as though the medication has done something strange to your face. Usually, what we’re seeing is much simpler: you’ve lost weight, and your face has lost volume too.
The temples, cheeks and under-eye area don’t necessarily change at the same rate. Skin may not adapt at the same pace either. So the question for me isn’t, “How do we fix GLP-1 face?” It’s: could we have planned for some of these changes earlier?

September consultations are remarkably predictable.
Pigmentation that had settled is visible again. A few kilos have crept back on. Skin that looked good in June suddenly feels dull, dry or just… different. None of those things particularly surprise me after summer. What matters is working out what actually changed before deciding what needs treating. September isn’t really about correcting everything you see. It’s about taking stock.