A More Beautiful Youthful You

At Modern Aesthetic Institute in Bakersfield, oculoplastic surgeon Joseph H Chang MD practices the most advanced techniques for plastic surgery of the eyelids and aesthetic facial rejuvenation to enhance your appearance and reveal a more beautiful, youthful you.

Modern Aesthetic Institute

MISSION

To elevate natural beauty through the advanced art and science of modern medical and surgical aesthetics, with a particular focus on enhancing the eyes and face.

VISION

To become Kern County’s most trusted provider of medical aesthetics, delivering world-class results, exceptional hospitality, and outstanding value.

Joseph H Chang MD

Joseph H Chang MD is the driving force behind the Modern Aesthetic Institute in Bakersfield, California.

“The real voyage of discovery consists not in seeing new landscapes, but in having new eyes.”

Marcel Proust

 

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Joseph H Chang MD

Joseph H Chang MD is the driving force behind the Modern Aesthetic Institute in Bakersfield, California.

“The real voyage of discovery consists not in seeing new landscapes, but in having new eyes.”

Marcel Proust

Services

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Eyelid Surgery

Whether you have droopy upper eyelids or puffy lower eyelids, blepharoplasty can help rejuvenate your entire eye area.

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legs thighs body contouring bakersfield

Wrinkle Treatment

Turn back time and smooth out those fine lines and wrinkles with the most effective wrinkle relaxer injections.

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legs thighs body contouring bakersfield

Dermal Fillers

Reverse the effects of aging and regain a more supple and youthful appearance with dermal fillers.

Surgical
Rejuvenation

Surgical rejuvenation offers transformative solutions to restore youthful beauty, addressing facial and body concerns with precision techniques, delivering natural, long-lasting results, and boosting confidence through enhanced appearance and renewed vitality.

Medical
Aesthetics

Medical aesthetics combines advanced procedures and treatments to enhance natural beauty, improve skin health, and address aging concerns, offering personalized, non-invasive, and minimally invasive solutions for a refreshed, youthful appearance.

Medical
Aesthetics

Medical aesthetics combines advanced procedures and treatments to enhance natural beauty, improve skin health, and address aging concerns, offering personalized, non-invasive, and minimally invasive solutions for a refreshed, youthful appearance.

MAI Client reviews

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FAQ

We specialize in advanced aesthetic injectables (Botox, Dysport, and dermal fillers including Sculptra) and oculoplastic eyelid surgery (upper and lower blepharoplasty). Our treatments are designed to enhance your natural beauty with precision and artistry.

Our practice blends cutting-edge medical expertise with artistic sensibility. Dr. Chang’s extensive experience, focus on quality, and integration of art into our aesthetic services create a truly bespoke and transformative experience for our clients.

During your consultation, Dr. Chang will assess your concerns, discuss your goals, and recommend the best treatment plan tailored to your needs.

Yes, our goal is to enhance your natural beauty while maintaining a balanced and refreshed appearance. Dr. Chang’s artistic approach ensures subtle, yet impactful, results.

The longevity of results varies by treatment. Botox typically lasts 3-4 months, while dermal fillers can last 6-18 months, depending on the product used.

Blepharoplasty is a cosmetic eyelid surgery designed to improve the appearance of the upper or lower eyelids by removing excess skin, fat, and muscle. It can rejuvenate tired-looking eyes and restore a youthful appearance.

Dr. Chang uses advanced techniques to minimize scarring. Incisions are strategically placed to blend with the natural contours of your eyes.

Yes, we offer a portfolio of before-and-after photos during your consultation to help you visualize the potential results.

During your first visit, Dr. Chang will discuss your aesthetic goals, assess your medical history, and recommend personalized treatment options to achieve your desired results.

Yes, all our treatments are performed by licensed and certified professionals with extensive experience in aesthetic medicine, ensuring the highest safety standards.

Results from injectables can typically be seen within a few days, with full effects visible after two weeks. The longevity of results varies depending on the specific treatment and individual factors.

Yes, we provide various financing plans to make our services accessible. Please contact our office to discuss the options available to you.

Botox relaxes muscles to reduce the appearance of wrinkles caused by facial expressions, while dermal fillers add volume to areas with deep lines or hollowing. Dr. Chang can advise on the best option based on your aesthetic goals.

Common side effects are usually mild and temporary, such as redness, swelling, or bruising at the injection site. Dr. Chang will discuss potential side effects and how to manage them during your consultation.

Eligibility depends on various factors, including your health, medical history, and aesthetic goals. A comprehensive consultation with Dr. Chang will determine the most suitable treatments for you.

Yes, combining treatments is often possible and can be more convenient. Dr. Chang will create a customized treatment plan to address all your aesthetic concerns efficiently.

Recovery times can vary, but most patients return to work after 48hrs depending on what they do for work. Dr. Chang will provide detailed post-operative care instructions to facilitate a smooth recovery.

Preparation varies by procedure. Generally, we recommend avoiding certain medications and supplements that can increase bleeding. Specific instructions will be provided during your consultation.

Filler has immediate results as it fi
the area being injected. Dysport on the other hand relaxes the injected areas but does
not fill. A good example, filler in the lips will result in your lips being enlarged as
disport wouldn’t go directly in the lips for enlargement but you can inject around the lips
to create a fuller looking pout, this is called a “lip flip”

Filler is typically placed in areas such as the lips, cheeks
temples, smile lines and under eyes.

Most fillers last up to a year. Depending on the area inject
some areas may last longer than others and it also varies from patient to patient.

Yes, you can. We just
recommend no hard massaging in the treated areas.

Dysport and Botox are both
neurotoxins, the difference between the two are brands. Dysport is under Galderma and
Botox is under Allergan. We carry both brands at our offic

Absolutely! After your consultation, together we can
determine the best course of action for your skin goals and depending on the treatment
plan we can typically get started right away.

Our goal for all
of our patients who receive eyelid surgery is for them to look their best-self meaning you
still look like you but refreshed.

Every patients healing will differ from
patient to patient, most patients have minimal bruising. At your consultation we will
discuss how to best prevent bruising.

Depending on the procedure(s) you elect the
surgery time can vary from 30 minutes to about an hour.

Our clients consider us a top-tier medical spa because we blend over 25 years of experience, advanced aesthetic technologies, and a unique focus on artistry. Led by Dr. Joseph Chang, we offer a high-end experience grounded in medical precision and personal care.

Blog

Close view of a mature woman's eye and brow illustrating eyelid surgery candidacy

Am I Too Old for Eyelid Surgery? What Decides Candidacy

There is no single birthday that automatically makes someone too old for eyelid surgery. Candidacy depends on general health, eye comfort, eyelid anatomy, medications, healing risk, and whether the expected change matches your goals. What matters more than age? General health. Your medical history helps determine whether an elective procedure is appropriate. Eye surface and tear film. Existing dry-eye symptoms and eyelid closure need careful evaluation because eyelid surgery can affect ocular comfort. Medications and supplements. The surgical team reviews products that may affect bleeding, anesthesia, or healing. Do not stop a prescribed medication without guidance from the prescribing clinician. Anatomy. Loose skin, brow position, and ptosis can look similar but may require different plans. Goals. A sound plan aims for a result that fits the rest of the face while preserving eyelid function. A recent American Academy of Ophthalmology evidence review found that published studies generally reported benefit after upper blepharoplasty or ptosis surgery, while most studies evaluating dry-eye symptoms found no significant worsening of subjective measures. Evidence varies by procedure and patient, which is why screening matters. Read the AAO report on upper-eyelid surgery outcomes. Loose eyelid skin and ptosis are not the same Dermatochalasis is excess upper-eyelid skin. Ptosis is a lower-than-normal eyelid margin caused by the lifting system of the lid. They can occur together. An examination measures eyelid position and muscle function and also considers whether the brow is contributing. Explore upper-eyelid blepharoplasty and ptosis repair if heaviness or a drooping lid is the concern. Lower-eyelid bags require a different evaluation, described on our lower-eyelid rejuvenation page. Can hooded eyelids affect vision? Upper-eyelid skin or ptosis can reduce the superior visual field in some patients. Symptoms alone do not identify the cause. A clinical examination and, when appropriate, visual-field testing help document whether eyelid position is affecting function. How is the procedure planned for an older adult? The plan should account for thinner tissues, brow position, eye closure, and the amount of skin that can be removed safely. A peer-reviewed discussion of blepharoplasty in aging patients emphasizes conservative tissue removal and harmony with the rest of the face. Anesthesia and procedure setting are individualized. The American Society of Plastic Surgeons notes that eyelid surgery may use intravenous sedation or general anesthesia, with the choice made by the treating team. Ask what is planned for your procedure and why. What should you ask at a consultation? Is the concern loose skin, ptosis, brow position, or a combination? Does my eye surface or dry-eye history change the plan? What medications or health conditions matter? What result is realistic for my anatomy? What recovery support will I need? Dr. Joseph H. Chang, MD, is an ophthalmologist with fellowship training in oculoplastic surgery at UCLA’s Jules Stein Eye Institute. To discuss whether eyelid surgery fits your health and anatomy, request a consultation at 4000 Empire Dr., Suite 300, Bakersfield, CA 93309, or call 661.535.0149. Frequently asked questions Am I too old for eyelid surgery at 65 or 70? Age alone does not decide candidacy. General health, eye health, medications, anatomy, healing risk, and goals all matter. Can hooded eyelids affect vision? They can in some patients. An examination and, when appropriate, visual-field testing help identify whether excess skin or ptosis is affecting the superior field of vision. Is dry eye a reason I cannot have blepharoplasty? Not automatically. Existing symptoms should be evaluated because eyelid surgery can affect eye comfort and closure. The findings may change timing, technique, or aftercare. Is eyelid heaviness always excess skin? No. Excess skin, ptosis, brow position, and other anatomy can create similar appearances. The correction depends on the cause.

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Mature woman with natural eyelid creases illustrating healed blepharoplasty scars

Are Blepharoplasty Scars Visible? What Eyelid Surgery Scars Look Like

Blepharoplasty scars are often placed where normal eyelid anatomy helps conceal them. An upper-eyelid incision usually follows the natural crease. A lower-eyelid incision may sit just below the lashes or, in selected cases, on the inside of the lid. Every surgical incision heals differently, so no surgeon can promise an invisible scar. Where are blepharoplasty incisions placed? For upper-eyelid surgery, the incision commonly follows the crease that folds when the eye opens. It may still be visible with the eye closed or during early healing. For lower-eyelid surgery, a subciliary incision sits just below the lash line. A transconjunctival approach uses an incision inside the lower lid, so there is no external skin incision. The internal approach does not remove excess skin and is not right for every anatomy. The American Society of Plastic Surgeons illustrates these common incision locations. What do eyelid scars look like while healing? Early incision lines can look pink, firm, or slightly raised while swelling and bruising settle. They often soften and fade over the following months. The line seen at six weeks may not represent the final appearance. Skin characteristics, sun exposure, smoking, incision care, and individual healing all influence the result. Recovery is broader than scar appearance alone. Our blepharoplasty recovery timeline explains common stages, while your own surgeon’s instructions control your care. How can you support healing? Follow the written aftercare plan for cleaning, ointment, and activity. Protect the area from sun as directed. Do not apply makeup or scar products until your surgeon says the incision is ready. Do not smoke during the healing period. Keep follow-up appointments, even when healing seems routine. When should you call the office? Contact the surgical team promptly for increasing pain, warmth, drainage, worsening redness, a sudden vision change, or a change in eyelid position. If a scar becomes thicker, wider, or more raised over time, ask for an evaluation instead of treating the eye area on your own. Why the preoperative plan matters Incision choice depends on whether the concern involves skin, fat, eyelid position, or a combination. Dr. Joseph H. Chang, MD, is an ophthalmologist with fellowship training in oculoplastic surgery at UCLA’s Jules Stein Eye Institute. He performs eyelid surgery at Modern Aesthetic Institute and evaluates the eyelids, tear film, and surrounding anatomy together. To discuss where an incision might sit for your anatomy, request a consultation at 4000 Empire Dr., Suite 300, Bakersfield, CA 93309, or call 661.535.0149. Frequently asked questions Will a blepharoplasty scar disappear completely? No surgical incision can be guaranteed to disappear. The goal is a fine line placed within normal eyelid anatomy that becomes less noticeable as it matures. Does a transconjunctival incision leave an outside scar? It uses an incision inside the lower eyelid, so there is no external skin incision. It is generally used when the plan does not require removal of lower-eyelid skin. How long do eyelid scars stay pink? Pinkness often settles over months rather than days. Individual healing varies, so your surgeon should assess any line that becomes more red, raised, or uncomfortable. When can I put makeup on an eyelid incision? Wait until your surgeon confirms the incision has healed enough. Applying makeup too early can irritate the area and may raise infection risk.

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Warm neutral consultation room illustrating Sculptra treatment planning

How Many Sculptra Vials Do I Need? A Bakersfield Guide

There is no universal Sculptra vial count. The number depends on the areas being treated, the amount of volume change, skin and tissue characteristics, and the result you want. A consultation is the only reliable way to estimate a personal plan. What FDA study dosing tells us FDA labeling gives useful context, but it is not a prescription for every patient. In the original facial-wrinkle study, the mean total injected volume was 11.7 mL per participant across a mean of 3.2 sessions. The historical instructions used 5 mL of sterile water per vial. That arithmetic is roughly two to three vials across the study course, not two to three vials for every person. Current US instructions allow either 5 mL or 8 mL reconstitution and describe treatment in up to four sessions, based on the study and the result being sought. Because reconstitution volume and treatment technique can vary, milliliters should not be treated as a simple vial calculator. You can review the current FDA Instructions for Use. Why vial counts vary Treatment area. A small, focused concern and broader facial volume change are different plans. Anatomy and starting point. Bone structure, soft-tissue support, asymmetry, and prior treatment all matter. Goals. A subtle change may use a different course than broader correction. Staged treatment. Sculptra works by stimulating collagen over time, so reassessment between visits is part of planning. The popular “one vial for every decade of age” rule is not part of FDA labeling and should not replace an examination. Age alone does not reveal where volume has changed or how much correction is appropriate. How Sculptra differs from hyaluronic acid filler Sculptra is injectable poly-L-lactic acid. Its effect develops gradually as collagen production changes in the treated area. Hyaluronic acid fillers provide volume through the gel itself. The right option depends on the concern, timing, anatomy, and risk discussion. Read more about dermal filler options in Bakersfield. What to ask at a Sculptra consultation Which areas would you treat, and why? What vial range do you expect across the full plan? How many sessions may be needed? When will the plan be reassessed? What risks, alternatives, and aftercare apply to me? Modern Aesthetic Institute is led by Dr. Joseph H. Chang, MD. To discuss a personal plan, request a consultation at 4000 Empire Dr., Suite 300, Bakersfield, CA 93309, or call 661.535.0149. Frequently asked questions How many Sculptra vials does a typical person need? There is no single typical number. FDA study averages provide context, but a personal plan depends on anatomy, treatment area, goals, reconstitution, and the number of sessions. Is one vial per decade of age accurate? No FDA rule sets vial count by age. It is a shortcut that does not account for anatomy, treatment area, or the result you want. Is Sculptra usually completed in one session? It is commonly planned as a series with reassessment between visits. Current FDA instructions describe up to four sessions in the study framework, but an individual plan may differ. How long can Sculptra results last? Current FDA labeling reports post-approval follow-up through three years for nasolabial folds and other facial wrinkles. Safety and effectiveness beyond three years after the first injection have not been investigated. Individual duration varies, and no result is guaranteed.

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Can Sculptra Be Reversed? What to Know Before Your First Vial

Not in the way a hyaluronic acid filler can be. Sculptra cannot reliably be reversed with an enzyme, because it is poly-L-lactic acid and there is no approved agent that dissolves it the way hyaluronidase dissolves hyaluronic acid. What Sculptra does instead is fade. Your body breaks the material down over time and the collagen response settles gradually. Unwanted results are generally managed, not undone. That is the honest short answer, and it is worth understanding properly before you book. The reversal question is really a question about commitment, and commitment is the whole reason people hesitate on Sculptra. Why Sculptra cannot be dissolved like other fillers Most of the injectables people know are hyaluronic acid fillers, and part of their appeal is that they come with an undo button. If one is placed badly, sits too superficially, or is simply not what the patient wanted, an injector can use hyaluronidase, an enzyme that breaks hyaluronic acid down. Sculptra is a different category of product entirely. It is a collagen stimulator, not a volumizer. The active ingredient is poly-L-lactic acid, a synthetic, biodegradable polymer. Rather than sitting in the tissue and taking up space, the particles prompt your own body to lay down new collagen over a period of months, and the visible change comes from that collagen and not from the injected material itself. That difference is exactly why hyaluronidase is not the answer here. Hyaluronidase is specific to hyaluronic acid. The clinical reference StatPearls states plainly that there is no antidote that dissolves poly-L-lactic acid. A 2025 review in the Journal of Cosmetic Dermatology notes that hyaluronidase has been tried on poly-lactic acid nodules and reports that the approach is not particularly effective. There is a second reason. Even if every particle were removed tomorrow, the collagen your body already made would remain. That collagen is your own tissue. Our guide to Sculptra’s collagen timeline walks through that process in detail. What actually happens to Sculptra over time Sculptra is not designed to stay in your face indefinitely. The polymer is biodegradable, and the body metabolizes it. On duration, it is worth being precise about whose claim is whose. Galderma, the manufacturer, states that Sculptra provides sustained results for up to two years, based on a clinical study that ran to 96 weeks, and Galderma’s product documentation notes that safety and effectiveness beyond two years have not been studied in controlled trials. Beyond that point, the honest answer is that the controlled data runs out. For most patients this reframes the question. Sculptra fades on its own schedule. It is not a decision you are locked into for life, and it is not one you can take back next week. It sits in between, which is uncomfortable for anyone wanting certainty. What can be done if you do not like your result This is the part patients actually want answered. There is no single answer, because what helps depends on what is actually bothering you, and a few things are worth knowing. Time and observation. Because the material breaks down and the collagen response settles, some concerns that feel urgent at three months read very differently at twelve. Massage. Galderma’s product documentation describes massaging the treated area for five minutes, five times a day, for five days after treatment. Follow the aftercare instructions your own injector gives you. It is a prevention measure aimed at even distribution, not a correction for a result you dislike. If a firm nodule or papule forms, that is a specific clinical finding and it needs to be looked at in person. Contact the practice that treated you. What to do about a nodule depends on the nodule, and it is a physician’s judgment rather than something to plan from an article. One distinction is worth holding onto. A nodule is a clinical finding and it should be assessed. Being unhappy with how much volume you have is a different question, and it does not have the same answer. That one is worth raising with your injector, and it is worth remembering that the material fades on its own schedule. Why your injector matters more than your exit plan There is a reasonable conclusion buried in all of this. When a product has no reversal agent, the quality of the decision going in carries more weight than it would with a product that does. That means an honest assessment of whether Sculptra suits your concern in the first place. It means conservative dosing across sessions instead of chasing an immediate result, because the collagen takes months to appear and overcorrection is the predictable consequence of judging too early. Our post on why choosing an experienced injector matters covers that judgment in more depth. It also means knowing what normal looks like afterwards. Early puffiness in particular gets confused with a finished result. Our guide to Sculptra swelling covers what is expected and what is worth a phone call. What Sculptra is actually approved to treat According to the FDA’s premarket approval record, Sculptra was first approved in 2004 for restoration and correction of the signs of facial fat loss, or lipoatrophy, in people with HIV. A 2009 supplemental approval, granted for Sculptra Aesthetic, covers use in immune-competent people as a single regimen for correction of shallow to deep nasolabial fold contour deficiencies and other facial wrinkles where a deep dermal cross-hatch injection technique is appropriate. Galderma’s documentation also advises against injecting where there is active inflammation or infection at the treatment site, and lists keloid or hypertrophic scarring among possible reactions. Your own history is part of the consultation. Who leads Modern Aesthetic Institute Modern Aesthetic Institute is led by Dr. Joseph H. Chang, MD, an ophthalmologist and oculoplastic surgeon with 25+ years of experience and fellowship training in oculoplastic surgery at UCLA’s Jules Stein Eye Institute. Frequently Asked Questions Can hyaluronidase dissolve Sculptra? Not effectively. Hyaluronidase breaks down hyaluronic acid, and Sculptra is poly-L-lactic acid, a different material. The clinical reference

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eaceful facial expression showing lower face area where filler treatment restores youthful definition

Masseter Botox in Bakersfield: Relief for TMJ, Jaw Clenching, and a Slimmer Jawline

In short: Botulinum toxin injections into the masseter are an off-label use. Some clinicians consider this treatment when evaluating concerns related to jaw clenching, teeth grinding, muscle tension, or jawline width. FDA has not established BOTOX Cosmetic as safe and effective for these uses. Results and risks vary. Temporary chewing weakness can occur, and a consultation is needed to evaluate possible dental or medical causes. If you wake up with a sore, tired jaw, if your dentist has pointed out worn or cracked teeth, if you get headaches that start at your temples, or if your jaw looks wider and more square than you would like, the cause may be the same muscle: the masseter. Masseter Botox is one of the most effective ways to calm that muscle down, and it solves a medical problem and a cosmetic one at the same time. This is Botox used well beyond wrinkles. Here is how it works, who it helps, and what to expect. Dr. Joseph H. Chang at Modern Aesthetic Institute in Bakersfield has 25+ years of injectable experience and has 25+ years of injectable experience. He trained in oculoplastic surgery at UCLA’s Jules Stein Eye Institute, so he brings surgical-level knowledge of facial anatomy to an area where dose and placement decide whether you get relief and a natural result, or a weak bite and an uneven jaw. What the masseter muscle does, and what Botox changes Put your fingers on the back corner of your jaw and clench. The muscle that pops out is the masseter. It is one of the strongest muscles in the body for its size, and its whole job is to close your jaw. When it works too hard, from stress, habit, or a bite problem, it can grind your teeth at night, ache during the day, refer pain into your temples as headaches, and grow larger over time, which widens the lower face. Masseter Botox works by relaxing that muscle. A few precise injections into each masseter reduce how forcefully it can contract. It keeps enough strength for normal eating and talking, but it can no longer clench with the same crushing force. Two things follow: the symptoms of overuse settle down, and because a muscle that works less gradually gets smaller, the jaw slims over the following weeks. The two reasons people get it For relief (the medical reason). Botulinum toxin injections into the masseter are used off-label by qualified clinicians for concerns that may include: If you grind your teeth, this can also protect your teeth and dental work from the wear that clenching causes. For shape (the cosmetic reason). A strong, overdeveloped masseter makes the lower face look wider and more square. As the muscle relaxes and gradually reduces, the jaw softens into a slimmer, more tapered shape. Many patients come in for one reason and are happy to get both. What to expect: the appointment, timeline, and units The appointment. The treatment takes about 15 minutes. Dr. Chang places a few injections into each masseter, which you can feel as quick pinches. No numbing is usually needed, and you can drive yourself home and return to normal activity the same day. How many units. The masseter is large and powerful, so it needs more units than a forehead or crow’s feet treatment. A typical starting dose is around 25 units per side, with stronger or larger muscles needing more. Dr. Chang sets your dose based on how strong your muscle is and whether your goal is relief, slimming, or both. When you notice it. If you are treating clenching or pain, relief usually begins within 1 to 2 weeks, often first felt as waking up with a looser, less tired jaw. The slimming effect is slower on purpose. The muscle shrinks gradually over 4 to 8 weeks, with the fuller change visible by two to three months. Downtime. Essentially none. You may have tiny marks at the injection points for an hour or two. The main aftercare is simple: stay upright for about four hours and avoid hard chewing right after. How long it lasts Masseter Botox lasts about 4 to 6 months, which is longer than Botox in the small muscles of the upper face. It also tends to improve over time. Because the muscle stays relaxed and smaller with repeat treatment, many patients find that after a few rounds they can stretch the interval and, for the slimming effect, hold their result with less frequent visits. Who it helps most, and who it does not It is a strong fit if you clench or grind, wake with jaw pain or headaches, or want to soften a wide, square jawline caused by muscle bulk. It is not the answer for every jaw concern. If your lower face looks full because of fat or loose skin rather than muscle, Botox will not change that, and a different treatment fits better. If your jaw pain comes from a joint problem inside the TMJ rather than muscle overactivity, Botox can ease the muscle component but is part of a larger plan. This is exactly what a consultation sorts out. Dr. Chang will feel the muscle, ask how your symptoms behave, and tell you honestly whether masseter Botox is the right tool for your jaw. Why the injector matters for this muscle The masseter is not a beginner’s injection. Place the units too high, too shallow, or in the wrong part of the muscle and you can create an uneven bite, a bulge when you chew, or an asymmetric jaw. Dose too aggressively and chewing feels weak. Dose too lightly and you get no relief. This is where deep anatomy knowledge earns its place. Dr. Chang’s oculoplastic surgery background means he maps the muscle precisely before he injects, and His extensive Dysport experience reflects consistency across thousands of patients. His approach here is the same as everywhere else in the face: enough to solve the problem, never more than the muscle needs.

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