Oval of the face

The oval of the face: how to redraw, reshape, firm or tighten the lower face

Doctor POIGNONEC plastic surgeon in Paris

What to do when you have a collapsed oval face

According to numerous scientific studies, the process of skin ageing begins from the age of 25, particularly with wrinkles on the forehead and crow’s feet. From the age of 30, some dermatologists recommend facial gymnastics to prevent softening of the tissues. Indeed, it is from around 40 years of age that the oval of the face tends to “come down”. The contours are less clear, lower cheeks appear, separated from the chin by a depression. Many women are then looking for a solution to redraw, remodel, firm or tighten their collapsed oval. Depending on their age and the stage of sagging skin, I offer different treatments, which give excellent results: Three treatments to redraw and reshape the oval of the face without surgery and a light and natural surgical treatment to tighten the oval of the collapsed face.
  • HYALURONIC ACID: redraw, reshape the oval of the face
  • TISSULAR INDUCTORS (« Radiesse® » (hydroxyapatite), « Sculptra® » (polylactic acid) or « Elancé » (polycaprolactone) : redraw, reshape the oval of the face
  • FRACTIONAL RADIOFREQUENCY : firm, tighten the oval of the face
  • THE MINI FACELIFT OF THE OVAL OF THE FACE : tighten the oval of the face

Hyaluronic Acid : redraw the facial oval

Hyaluronic acid is a substance that exists naturally in our body to maintain skin hydration because it has the property of retaining large amounts of water. Unfortunately, it diminishes with age, which is why the skin becomes sagging and wrinkles and hollows appear. I have a wide range of high quality hyaluronic acids in my practice, and I will choose the one that best matches to redraw your oval, i.e. a more or less dense hyaluronic acid depending on the volume I wish to obtain. This is called the “cross-linking” criteria. The injections are practically painless, but you can benefit from a local anaesthetic depending on your sensitivity, either with an anaesthetic ointment that is applied to the skin, or with an anaesthetic injection, as at the dentist. You can also breathe using a gas mask, which acts by decreasing your sensitivity to pain and allows you to be more relaxed. It is a gas that has no anesthetic effect and is used regularly in adults and children over 1 month. You can go home after the session without any problems. Then, depending on the density of the product and the desired effect, I will use either needles of different diameters or cannulas with rounded tips. The product will be distributed to redraw, remodel your oval. The result will be immediate and will improve during the following days thanks to the hydrophilic character of the hyaluronic acid (which retains water). Your oval will be redesigned and the effect, depending on the product chosen, will last from 12 to 18 months. Rare bruises may appear, which disappear quickly. Arnica-based ointment can be applied in this case. Book your consultation at the doctor’s office on the Internet to firm up the oval of your face in Paris Make an appointment by Phone. : +33 (0)1 45 63 13 20 Monday to Friday 09:00 AM – 08:00 PM and Saturday morning

Oval of the face : reimbursement and management

All these procedures to correct the oval of the sagging face are aesthetic treatments that are not covered by Social Security. They can therefore not benefit from reimbursement by Social Security.

The tissue inducers : redraw, reshape the facial oval

Marketed under the names « Radiesse® », « Sculptra® » or « Elancé » among others, tissue inducers are injectable implants, totally biodegradable, composed of a tissue inducer and an excipient gel. Very frequently used in plastic surgery, they make it possible in particular to redraw the contours of the face. Once injected, they can be shaped to recreate volumes, harmonize curves, reshape the oval of your face. Their goal is to first perform an immediate filling effect through the gel, and then to have the tissue induction reaction by stimulation of fibroblasts that will make collagen. There is therefore a real increase in the soft tissues of the deep and subdermal dermis of the oval region of the face, and a real restoration of the lower part of your face. The oval is also firmed. The injection conditions are the same as for hyaluronic acid. Local anaesthesia can also be performed. The areas are injected with a fine needle or a foam cannula and the product is then immediately massaged, moulded onto your face, so that it is firmly in place. The result is immediate but will be optimal if the injections are repeated every month for 3 months until the expected result. The effect may persist in most patients for up to 2 years.

The mini face lift of the face oval : tighten the face oval

Injections of hyaluronic acid, hydroxyapatite and radiofrequency give good results but have their limits when skin sagging is too great. Too many injections can result in a facial expression that is slightly enlarged. From about fifty years of age it is sometimes necessary to associate a gesture of tensioning to keep the smoothness of the bottom of the face and its slightly triangular aspect. This gesture will then make it possible to correct in only one time what bothers you: it is about the mini face lift of the oval or the mini face lift of the bottom of the face. The operation is performed in a clinic, under local anaesthesia combined with a mild sedation and outpatient. Through a perfectly concealed incision around the ear, the skin is lifted off a few centimeters. Muscles and skin are tightened and sutured. The excess skin is then removed which gives an immediate result: the oval of your face is tightened, the mandibular angle well drawn. When a slight greasy impasto makes the contours heavier, a small liposuction under the chin or along the mandible can complete this treatment. A simple lipo aspiration can then be performed, i.e. the fat is sucked in using micro-canulas, or a laser lipolysis, i.e. a laser cannula is first passed to the suction cannulas, which induce heat under the dermis causing skin retraction. After the operation, there is a slight oedema and bruising which disappears between 3 and 15 days depending on the patient (depending on health, age, smoking, sun, etc…). The result is immediate since the skin and muscles are tightened surgically, and lasts between 5 and 10 years.

Fractional radiofrequency : firm, tighten the oval of the face

When the sagging of the skin is a little more important, it is interesting either to use radiofrequency alone or in complement of injectable products. It is a device that is applied to the surface of your skin and delivers radio waves. The goal is a thermal effect on the dermis respecting the epidermis:
  • It allows a tensioning of the collagen with an immediately visible but not very durable tensor effect
  • The creation of dermal microscars leading to collagen stimulation with a more lasting effect for a few months.
The oval of your face is then immediately firmed and slightly tightened. It is possible to perform this treatment under local anesthesia like all other procedures. The “shots” cause a sensation of heat. Small red squares appear on the surface of the skin, then microcroutelles for a period varying from 1 to 4 days. A sunscreen cream is mandatory and make-up is allowed from the next day. It is a non-invasive and risk-free method. Depending on your sagging skin, 1 to 5 sessions spaced 3 weeks apart are necessary to tighten your oval. Then, the result can be maintained with 1 or 2 sessions per year. The result depends on the skin and its retraction capacity which varies according to the person (skin laxity, smokers, thick skin).


Whether you are 30 or 70 years old, the current means of science make it possible to correct the misdeeds of time safely and very effectively. But it is only after a consultation in my office and a thorough examination of your face that we can choose together the treatment that will give the best result. I will also make a precise evaluation of your state of health, because certain procedures can present contra indications. An interrogation and a precise information will make it possible to choose the most adapted product in your case. Facial oval Source : Best excerpt from the book « La chirurgie esthétique, les solutions et les conseils de mon chirurgien » © Ambre Editions | Author : Dr. Sylvie POIGNONEC – Plastic and Aesthetic Surgeon, located in the heart of Paris, specialized in plastic, aesthetic & reconstructive surgery