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the long-acting anesthetic Exparel, most patients experience zero pain and require no narcotics postoperatively. It’s a radically different experience - one that reflects my commitment not only to beautiful results, but to human-centered care at every step. ML: You coined the term “Aesthetic Facial Balancing” long before it became a buzzword. What inspired this technique, and how does it differ from what people might experience with traditional filler treatments? Dr. Maercks: Aesthetic Facial Balancing emerged from a deep dissatisfaction with what I saw as a fragmented and reductionist approach to facial aesthetics. In traditional filler treatments, there’s often an obsession with isolated features - lips, cheeks, nasolabial folds - treated independently and reactively. This tends to produce results that may address specific concerns but ignore the harmony of the whole. What results is often unnatural, exaggerated, and - ironically - less beautiful. My goal was to move beyond this piecemeal thinking. Aesthetic Facial Balancing (AFB) was born from years of interdisciplinary study- drawing from fine arts, philosophy, psychology, and even cultural anthropology. I became fascinated by the idea of why certain faces captivate us, why some people—despite deviating from “average” human proportions—are universally perceived as beautiful. I began exploring the phenomenology of perception: how beauty isn’t just recognized consciously, but felt, often within the first 200 milliseconds of visual processing. This is where AFB departs radically from conventional filler work. It’s not about fixing flaws - it’s about activating the unconscious perception of beauty that every human brain shares. My approach doesn’t cater to personal insecurities or trends; it addresses the underlying structures that determine whether a face “reads” as youthful, vibrant, and harmonious at the most primal level. To achieve this, I developed a unique framework based on the subunits of facial aging - the periorbital region, the perioral area, the jawline, the temples, and the frontal bone structure. These are the areas that undergo the most significant volumetric changes as we age, and they have a disproportionately strong impact on how we perceive a face. Critically, I treat these subunits holistically. Partially treating a subunit, or ignoring the dynamic relationship between them, leads to the unnatural, “puffy” look that we often see in poorly done celebrity work. With AFB, even large-volume treatments result in patients looking fresher, more elegant, and often even slimmer, rather than overfilled. It’s a process of revealing, not reshaping - a restoration of innate harmony that’s deeply human and undeniably compelling. The focus is again that timeless and natural beauty that just resonates and doesnt distract. ML: Many people are understandably anxious about surgical pain and recovery. Your use of Exparel and the tumescent technique seems revolutionary. How has this changed the patient experience at your practice? Dr. Maercks: Exparel as I use it in a tumescent or expanded form has absolutely revolutionized the patient experience in my practice. About a decade ago I started using exparel in the solution i used to minimize pain recovery and bleeding in every procedure I perform from facelifts to breast and body work and even genitalia reconstructions. I found with this perfected solution most patients experience zero postoperative pain even with abdominoplasty which is really incredible. I learned that this expanded exparel solution allowed me to also do just about any procedure without general anesthesia with a seamless, pain-free recovery. I love being able to offer patients pain-free surgery whether they are awake or asleep. I realized about a decade ago the biggest risk of using exparel in this way is that patients do not feel like they just had surgery so they may forget to take it easy and