When you look in the mirror and notice your cheekbones start to look more prominent and the temples above them look slightly hollow, what we commonly call a "peanut-shaped face" often comes to mind. Your profile might look quite slim, but from the front your face appears flat and wide, naturally making you think that reducing your cheekbones is the only solution you need. To put it simply, a peanut-shaped face is not just a problem of the cheekbones alone, but a structure where the three-dimensional volume both above and below the cheekbones has diminished. Therefore, we often recommend combining treatments that reduce volume with those that add volume.

This is not as simple as it seems because if you only reduce the cheekbones, the hollows in the temples above them can actually look even deeper. That's why it is helpful to understand beforehand which areas to reduce and which to fill so that you won't get confused during your consultation.

> This content is a summary of treatment information from Hapjeong Beauty stone.

By reading this article, you will learn:

• The structural reasons why a peanut-shaped face becomes prominent

• The limitations of only reducing the cheekbones

• The different roles played by Double Slim, Ulthera, and Sculptra

• Who makes an ideal candidate for this combination treatment

Why a Peanut-Shaped Face Looks Prominent

A peanut-shaped face typically involves a combination of three factors: cheekbones that flare outwards, slightly sunken temples above them, and hollow sub-cheek areas (the area in front of the ears and behind the cheekbones). Because the smooth line flowing from top to bottom is interrupted in the middle, the cheekbone area alone stands out.

In many cases, these facial structures do not actually have large cheekbones, but rather the cheekbones look more pronounced because the surrounding area has lost its youthful volume. Therefore, even if you only reduce the cheekbones, the impression of a flat and wide forehead and face from the front often remains. The upper temples and the hollow areas below the cheekbones need to be filled together so that the cheekbones can blend seamlessly into the surrounding contours. If your side profile looks fine but your front-facing photos look somewhat flat and wide, your facial structure likely fits this description.

The Limitations of Only Reducing the Cheekbones

If you only focus on treatments that reduce the cheekbones, you might encounter an unwanted outcome. As the temporalis muscle* next to the cheekbones is reduced, the hollow in the temples above can look even more pronounced. This is why some people feel their cheekbones look narrower after a treatment, but the upper face looks hollower, making them look tired.

*Temporalis muscle: This is the chewing muscle located above the temples. Reducing its volume with Botox narrows the temple area, but because this can leave the upper face looking hollow, we usually recommend adding volume to this area at the same time.

Conversely, if you only fill the hollows, the temples and sub-cheek areas will be filled, but the protruding cheekbones will still flare outwards, meaning the front-facing width of the face will not decrease. While you will gain volume, the impression of a wide front face remains. Therefore, a dual approach—reducing the cheekbones while filling the temples and hollow sub-cheeks—creates the most natural look. Botox works by blocking the release of acetylcholine, a neurotransmitter that signals muscles to contract, thereby relaxing the muscle and reducing the volume of the temporalis and cheekbone muscles.

The Different Roles of Double Slim, Ulthera, and Sculptra

Although all three treatments are designed for facial contouring, they each play a distinct role. Double Slim and Cheekbone Ulthera focus on reducing volume, while Sculptra focuses on filling and restoring volume. The table below outlines these differences clearly.

Double Slim is a dual-action method that administers Botox to both the cheekbone muscles and the temporalis muscles. Instead of just reducing the cheekbones, it also refines the upper facial contour by slimming the temporalis area. Cheekbone Ulthera is not a surgical procedure to shave down bones. Instead, it uses ultrasound energy to lift the sagging SMAS layer* below the cheekbones. Because micro-focused ultrasound works by stimulating the regeneration of collagen and elastin fibers deep within the skin, the results appear gradually over several weeks to months rather than immediately.

*SMAS layer (Superficial Muscular Aponeurotic System): This is a layer of muscle fascia situated about 4.5mm deep beneath the skin, and it is the precise target where Ulthera focuses its ultrasound energy.

Sculptra is a collagen booster formulated with poly-L-lactic acid (PLLA)* that slowly stimulates the skin to produce its own natural collagen from within. It restores volume and youthful fullness to sunken areas like the temples and hollow sub-cheeks. This ingredient is recognized for restoring volume as an absorbable, semi-permanent injectable that gradually induces collagen formation.

*Poly-L-lactic acid (PLLA): A biodegradable synthetic substance that stimulates collagen production as it naturally breaks down in the dermis. It is widely used in collagen boosters like Sculptra.

The time it takes to see results varies for each treatment. Botox works relatively quickly, while Ulthera and Sculptra show results gradually over several months as your natural collagen builds up. The diagram below shows the general process of how these three treatments combine to create a beautifully smooth, contoured jawline.

Who Benefits Most from This Combination Treatment?

This combination is highly effective for those whose cheekbones flare outwards while their temples and sub-cheeks are sunken. Conversely, a different approach may be more suitable for the following cases:

• If the cheekbones themselves are physically very large and bony — in this case, bone reduction surgery is usually more appropriate, as non-surgical reduction treatments have their limits.

• If the entire face is naturally plump and needs very little volumizing — a different treatment direction focusing solely on contouring rather than filling may be ideal.

• If you are pregnant, breastfeeding, have a history of keloid scarring, or are dealing with active skin infections — it is safest to consult with our medical team first to determine if you can receive the treatment.

During your consultation, there are three key details we will look at together. We will determine the dosage for Double Slim based on the thickness of your temporalis muscle, adjust the amount of Sculptra depending on whether we are filling just the temples or the sub-cheeks as well, and plan the timing carefully if you have an important event like a wedding coming up so your skin has enough time to fully recover.

How Hapjeong Beauty stone Approaches the Peanut-Shaped Face

Correcting a peanut-shaped face rarely comes down to a single treatment; instead, achieving a natural result requires balancing both reduction and volume restoration. At Hapjeong Beauty stone, rather than looking at the cheekbones in isolation and choosing a treatment, we prioritize assessing the overall balance of the face—including the temples and sub-cheeks—before determining the most effective combination. A board-certified dermatologist will personally evaluate the thickness of your temporalis muscle and the hollows of your face to customize the ratio of reduction to filling. Our clinic is within easy walking distance from Hapjeong Station, making it highly convenient for you to visit for follow-ups according to your healing schedule.

Frequently Asked Questions

Q. Can I receive all three treatments on the same day?

A. Yes, they are very commonly performed together on the same day. The typical sequence is to first relax the muscles with Double Slim, lift the sagging area below the cheekbones with Ulthera, and finally restore volume to the temples and sub-cheeks with Sculptra. The downtime is minimal, meaning most patients can return to their daily routines the very next day. However, since the optimal timing can vary depending on your unique skin condition, it is always safest to decide together during your personal consultation.

Q. When will I start seeing results?

A. The timeline is different for each procedure. Botox (Double Slim) begins to relax the muscles in 1 to 2 weeks, slimming the facial width, while Ulthera shows gradual improvement over 2 to 3 months as collagen regenerates. Sculptra also builds natural volume over a period of 1 to 3 months. The overall changes become most noticeable around the 2 to 3-month mark when the effects of all three treatments come together. Individual results may vary.

Q. I have large cheekbones. Can this combination make them smaller?

A. If your cheekbones are physically very large and bony, non-surgical slimming treatments have their limitations. This combination focuses on refining the cheekbone muscles, raising sagging tissues, and restoring surrounding volume to soften your appearance—it does not alter the underlying bone structure. If prominent bone structure is your main concern, we recommend consulting our medical team to see if bone contouring surgery would be a better option for you.

Q. How many vials of Sculptra will I need?

A. This depends on the area you wish to fill. The required amount varies depending on whether you undergo treatment for just the temples or the sub-cheeks as well. Rather than doing everything at once, we often recommend dividing the treatment into sessions based on the depth of the hollows. To ensure your safety, the precise dosage should be decided together with a doctor who has personally evaluated your facial structure.

Recommended Reading

• Cheekbone Ulthera: Do I need it on my entire face to see results?

• Full-Face Filler: Where and how much should be injected for natural results?

• Thermage vs. Ulthera: Why the choice should be different for those in their 30s vs. 40s

• The cost of Double Slim Injection: Why comparing the cost per session vs. the total package changes the math