Taula de Continguts
- What harmonizing a face means and what it does not mean
- How the medical team decides which protocol fits you
- The 4 protocols at a glance
- Female face: young protocol and mature protocol
- Male face: the general idea of the two protocols
- Safety: side effects and contraindications
- How we work at Santé Madrid
- Frequently asked questions
Facial harmonization in Madrid, at Santé, is organised into four starting protocols: young female face, mature female face, young male face and mature male face. Each one is a starting point that the medical team adjusts to your face after an assessment, combining only the techniques from our catalogue that are indicated for you. In this guide we explain what each protocol aims for, the criteria used to choose it, which techniques can be part of it and which risks are worth knowing before you decide.
Key points
- Santé Madrid approaches facial harmonization through four protocols: young female, mature female, young male and mature male.
- "Young" and "mature" describe what the medical team sees in your face, not a fixed age on your ID card.
- No protocol is a closed package: techniques are chosen after a medical assessment and only if indicated.
- Hyaluronic acid and botulinum toxin have side effects and contraindications that are reviewed in the consultation.
- Results vary with each face and each skin; the aim is balance, not a change of identity.
What harmonizing a face means and what it does not mean
Harmonizing is not filling wrinkles one by one. It is looking at the face as a whole and asking which area breaks the balance between the forehead, the midface and the lower third. A review published in Aesthetic Surgery Journal explains that facial aging happens "from the inside out": the bone changes, the fat pads shrink or shift, the muscles change their tone and the skin becomes thinner (Swift et al., 2021).
The same review describes two uses of this analysis: in younger people, helping to establish harmonious facial balance; in older people, restoring the balance lost over the years. That distinction helps explain the difference between our young-face and mature-face protocols.
What harmonization does not try to do is change who you are. It does not replace surgery, it does not make the face perfectly symmetrical and it does not copy someone else's features. Santé does not perform surgery, so if your goal can only be achieved in an operating theatre, we will tell you clearly in the consultation. Results vary with each face and each skin.
How the medical team decides which protocol fits you
The first criterion is the starting face, female or male, because the aesthetic goals and the way volume is distributed are usually not the same. The second criterion is what the examination shows, not your age. Some forty-year-olds have a face that is assessed as young, and some younger people have visible volume loss or laxity. That is why we do not give closed age ranges for each protocol.
During the assessment, the Santé Madrid medical team usually reviews these points:
- Proportion between the upper, middle and lower thirds of the face.
- Midface support: cheekbones, tear troughs and nasolabial folds.
- Contour definition: chin, jawline and the transition into the neck.
- Skin quality: hydration, texture, pigmentation and firmness.
- Expression lines in movement and at rest.
- Previous treatments, medication, allergies and medical history.
With that information a protocol is proposed and, within it, an order of priorities. Not everything is always treated in the same visit: the plan can be split into phases to see how your face responds and adjust along the way. If the assessment shows no clear indication, the recommendation may be not to treat yet, or to start with skin quality only.
The 4 protocols at a glance
This table works as an indicative menu. The techniques column lists treatments that are part of the Santé Madrid catalogue and that the medical team may consider within each protocol; it does not mean that all of them are applied, or applied to everyone.
| Protocol | What it usually aims for | Catalogue techniques that may be considered |
|---|---|---|
| Young female | Enhancing proportions and caring for skin quality | Hyaluronic acid in the lips, cheekbones or chin; skin boosters; Baby Glow; neuromodulators for expression lines |
| Mature female | Restoring support and improving apparent firmness | Hyaluronic acid in the cheekbones, temples, tear troughs or nasolabial folds; Nefertiti lift; Sculptra, Radiesse or Lanluma; polynucleotides; HIFU MPT |
| Young male | Defining structure without losing a natural look | Hyaluronic acid in the chin, jawline or cheekbones; rhinomodeling; neuromodulators for expression lines |
| Mature male | Restoring support while keeping masculine features | Hyaluronic acid in the temples, cheekbones or jawline; biostimulators; neuromodulators; HIFU MPT |
When neuromodulators appear, we mean botulinum toxin, a prescription medicine that is only used after a medical assessment and only if indicated. In the same way, the choice between hyaluronic acid, a biostimulator or a technology-based treatment depends on what you want to achieve in each area. The combinations and their order are decided case by case, and results vary with each skin.
Female face: young protocol and mature protocol
In the young female protocol, the face usually still has good support, and the work focuses on proportions and details. Options may include shaping or hydrating the lips, adding soft projection to the cheekbone or balancing the chin with the profile, always with hyaluronic acid and in prudent amounts. If the skin is dehydrated or dull, skin boosters or Baby Glow may be part of the plan. If there are marked expression lines, the team may consider neuromodulators, after a medical assessment and only if indicated.
In the mature female protocol, the priority usually shifts: the review by Swift et al. describes fat loss and displacement and bone remodelling as part of aging, and in many faces this can show in the midface. That is why the assessment looks at the cheekbones, temples, tear troughs and nasolabial folds, and at the contour with techniques such as the Nefertiti lift. When the main concern is skin quality or firmness, a biostimulator (Sculptra, Radiesse or Lanluma), polynucleotides or HIFU MPT may be considered. In both protocols, the prudent approach is usually to do less and review rather than correct an excess.
Male face: the general idea of the two protocols
The male protocols start from a simple idea: treating the face without feminizing it. In a male face, the team usually pays particular attention to the angle of the jaw, the chin and the forehead, and to how volume is distributed. That is why the assessment and the type of correction are not copied from the female protocol.
In the young male protocol, the usual aim is definition: chin, jawline or cheekbones with hyaluronic acid, and in some cases non-surgical rhinomodeling to balance the profile. In the mature male protocol, the loss of support in the temples and midface is added, along with contour definition and expression lines, for which neuromodulators may be considered after a medical assessment and only if indicated; biostimulators or HIFU MPT may be considered when the skin has lost firmness. In both cases, what we look for is a result that looks rested and like you. Results vary from person to person, and the final decision is always made in a medical consultation.
Safety: side effects and contraindications
No injectable is free of risk. On hyaluronic acid, an international expert consensus states that most reactions are mild and transient and that serious adverse events are rare, but they do exist: among early reactions it lists vascular compromise, inflammatory reactions, injection-related events and inappropriate placement of the product; among late reactions, nodules, granulomas and skin discoloration (Signorini et al., 2016). The same consensus stresses that knowing facial anatomy, selecting the right person and product and using appropriate technique reduce those risks.
On botulinum toxin, the summary of product characteristics of a medicine authorised for aesthetic use in Spain lists as contraindications hypersensitivity to the product, myasthenia gravis, Lambert-Eaton syndrome and infection at the injection site, and it does not recommend use during pregnancy or breastfeeding (summary of product characteristics, AEMPS CIMA). Among its adverse effects it describes pain, oedema or bruising at the injection site and drooping of the eyelid (ptosis), generally mild or moderate and transient. A recent narrative review also notes that complications from toxin, fillers and biostimulators should be recognised promptly so that they can be managed appropriately (review in Anais Brasileiros de Dermatologia, 2025).
How we work at Santé Madrid
Our clinic is at C. de Amador de los Ríos, 1, Chamberí, 28010 Madrid, and is open Monday to Friday from 9:00 to 21:00 and on Saturdays from 10:00 to 15:00. You can start with a free aesthetic consultation with a Beauty Coach, who helps you put your concerns in order and understand which options exist. Injectable treatments are always considered after a medical assessment, which takes place in the facial medical consultation; that consultation costs €50.
In that consultation, the Santé Madrid medical team examines your face, reviews your medical history and explains which starting protocol makes sense, which techniques it proposes, in what order and what risks each one carries. If something is not indicated, they will tell you that too. Beyond the face, we usually ask about your skincare routine: dry air, winter heating, sun exposure and the urban environment can affect hydration and how the skin looks, and that can influence whether it makes sense to start with skin quality before volume. We see patients from Chamberí, Almagro, Salamanca or Colón and from any other part of the city.
Frequently asked questions
What is the difference between the young and the mature protocol?
The young protocol focuses mainly on proportions, details and skin quality when the face still has good support. The mature one usually prioritises restoring support and apparent firmness. The choice depends on what the medical team sees in your face, not on a specific age.
Do I have to have every technique in a protocol?
No. Each protocol is a starting point. The medical team only proposes the techniques that are indicated in your case, and the plan can be split into phases to review how your face responds before continuing.
Does facial harmonization include botulinum toxin?
It may, but not always. Botulinum toxin is a prescription medicine that is used after a medical assessment and only if indicated. It has contraindications, such as pregnancy, breastfeeding or myasthenia gravis, and possible adverse effects such as bruising or a drooping eyelid.
Will the result look natural?
The aim of all four protocols is balance, not a change of identity, and the approach is usually to treat prudently and review. Even so, results vary with each face and each skin, and no specific result can be promised.
Can men have facial harmonization?
Yes. Santé Madrid has two male protocols, one for the young face and one for the mature face. Their general idea is to define or restore support without feminizing the features, always after a medical assessment.
How much does the first consultation cost?
The aesthetic consultation with a Beauty Coach is free and the facial medical consultation costs €50. The price of each treatment depends on the plan proposed, and we explain it in the consultation.
Who should not have facial harmonization for now?
It is better to wait if you are pregnant or breastfeeding, if you have an infection or an active lesion in the area, or if you have a neuromuscular disease or an allergy to any component. In any case, the decision is made in the medical consultation.
If you are thinking about facial harmonization, the first step is not choosing a technique but understanding what your face needs. Come and see us in Chamberí, tell us what you would like to change and what you would not, and the medical team will calmly explain which protocol makes sense for you.
