Dr. Dan Xu’s Insights on Aesthetic Judgment in Medical Cosmetics

Every day I consult with dozens of clients and perform fine-tuning injections, and I’ve noticed that people share similar confusion on their journey to look better—especially those new to medical aesthetics. There are so many treatments available, and it’s hard to know where to start. What kind of results can you expect? Today I’d like to briefly share my perspective on facial enhancement and some basic knowledge for your first visit. I hope this helps make your path to looking better clearer and safer. Most importantly, I hope that through changes in appearance, you become more confident and more truly yourself.

First, I recommend finding a clinic you trust that has a physician on site for consultations. Your first consultation should be where your trusted physician sets up a comprehensive, holistic, long-term treatment plan that both of you agree on—this plan must be long-term and mutually endorsed. After all, a beautiful life still has decades ahead, and prevention and gradual progression over those decades should all be considered. Don’t do something now just to look good for a few years and then ignore how you’ll look and how to maintain it afterward.

During the process of creating this plan, you can ask your physician as many questions as possible and clear up all your doubts, letting your physician’s professional knowledge give you clear answers. This is how you can reduce confusion and anxiety on your path to looking better. The most important step is to have your physician show you cases they have personally treated, and to analyze and compare the facial anatomy of those cases—the similarities and differences with your own (remember, they must be cases the physician personally performed).

Next, have your physician assure you that throughout the execution of this plan—even if a particular device isn’t operated by the physician—there is a physician physically present in the clinic who can guide the operation and handle unexpected situations at any time. This is already a legal requirement in Vancouver, and since it’s been written into law, there’s naturally a good reason for its existence.

During consultations, most people come with facial and body concerns they want to improve, but many are confused about what to do first, what to do later, and why doing a certain treatment first would give better results. These are questions you absolutely must clarify thoroughly during your first consultation with the physician, because most clinics only offer one free comprehensive physician consultation. Seize this opportunity and get the physician to answer you in as much detail as possible. Only when there is zero miscommunication between you and your physician, and you fully understand the treatments to be done, will your aesthetic journey have the least anxiety and the best results.

Let me briefly share my perspective on facial adjustment and aesthetics. I hope this approach can also help you choose the treatments that should be prioritized, rather than treatments that shouldn’t be done at this stage—which could cause you to completely lose confidence in medical aesthetics and have an unpleasant experience.

I believe that when doing facial shaping, what you should do first must be the treatment that boosts your appearance the most. I generally divide facial concerns into: skin issues, facial bone-structure shaping issues, and facial soft-tissue shaping issues. Skin issues are nothing more than spots, acne, acne scars, and pores. Bone-structure issues involve left-right facial proportion, the “three sections and five eyes” proportion, and front-to-back facial proportions (including the height difference between the forehead bone and the mid-face), the T-zone proportion, and even the ratio of the head’s crown height to face length. Soft-tissue shaping mainly refers to the “three-eight lines” (tear troughs, nasolabial folds, and marionette hollows).

For example, my clinic often has three or four close friends come in for a consultation together, and each has different skin and facial shaping concerns. Some people already have great bone structure and a good skin foundation, but their face is covered with spots and freckles. Without a doubt, the treatment they should do first is removing the spots. If at this point she wanted to work on her forehead or brow bone, the boost to her appearance (calculated as a percentage) might only be 4 to 5 points. But if she removes the spots first, the improvement might be 20 to 30 points—jumping from 65 to 95 at once—and then she can do treatments that add another 4 to 5 points, like fine-tuning an already attractive forehead to be more perfect and making the highlight points fit the “three sections and five eyes” proportions better. This is how you’ll gain more confidence in enhancing your appearance.

Some people feel they don’t look that beautiful—they don’t feel wowed by themselves in the mirror and don’t know where their facial concerns lie. Then they suddenly notice the tired tear troughs under their eyes, as if spotting a torch in the dark, and randomly pick a clinic to fix the tear troughs without any aesthetic consultation. After a recovery period of a week or two, they wait in front of the mirror, but instead of a stunning version of themselves, they still feel plain and ordinary, feeling that the real problem still hasn’t been solved.

Here’s another example: several close friends come in together, and there’s always one whose skin is especially good and whose soft tissue is also good, but whose bone structure is very flat with no dimension. People often say this girl doesn’t wow you at first glance, her face is a bit large, but she’s somewhat pretty and grows on you. Her core issue—the thing that would boost her appearance the most—is bone-structure shaping.

Generally speaking, bone-structure shaping means adjusting the height differences of the face, so that with the same absolute width the face looks more three-dimensional and visually narrower and smaller. What we call attractiveness is 90% determined by a slight profile view, because if you observe carefully, apart from when making eye contact, no one sees you at a full 100% frontal view—90% of the time there’s a bit of an angle. That means 90% of your attractiveness is determined by your profile, anywhere from 0 to 90 degrees. Just as a proper ID photo can never beat a slightly angled selfie. This also shows the importance of bone structure and facial height differences, and explains why a tiny change to the brow bone can significantly elevate the overall brow-and-eye area, making the brows and eyes come alive rather than looking like two lifeless drawn-on lines with no dynamic quality.

At this point, if this girl with good skin and good soft tissue but relatively lacking bone structure wanted to do a picosecond laser to make her skin more porcelain and glowing, or a gold microneedling treatment to refine her skin, I would rather recommend prioritizing bone-structure shaping. Even just slightly adjusting the brow bone to accentuate her already attractive eyes (soft tissue), making them look larger, brighter, and more three-dimensional—giving a slightly mixed-heritage look—would boost her appearance more than improving her skin first. Skin can be used later to fine-tune yourself toward greater perfection.

And then—you do all of this to be happier and live more confidently. Don’t base what you want to do on other people’s aesthetic value system. Not even on my aesthetic system. The reason I give you my suggestions is that seeing dozens of different female and male clients every day has trained me to spot at a glance which small adjustment can improve the overall proportions the most, produce the biggest change, and give the best result.

But what I say isn’t necessarily the most correct thing—you should have your own opinions too. I often hear clients say, “My boyfriend thinks I don’t look good here or there,” or “They all say something’s wrong with me here, so I want to…”—stop right there, sweetheart.

I believe looking better isn’t about getting more approval from others. Looking better is for yourself—to be more confident, youthful, and radiant, and to meet a more beautiful, better version of yourself.

IDentify your own beauty—recognize your beauty, accept yourself more, and have a landing point in life defined by you. Only then does looking better become more meaningful. In the end, the focus of everything we do is to be happy in this life. When your self-worth depends on other people’s evaluation systems, happiness becomes very unstable.