When it comes to cosmetic treatments, injectables can still feel taboo in the Black community. While the saying “Black don’t crack” often rings true, board-certified nurse practitioner Andi Assebian, MSN, AGNP-C, and founder of Derm Artisan wants us to keep an open mind to treatments.
“In this industry, it’s mostly Caucasian people who tend to be more open about it,” she explains. “When it comes to African American people, we’re still getting into it because we have a preconceived notion that Black don’t crack. I’m not saying that Black don’t crack—we have great genes. But, at the end of the day, we have to maintain what we have and age gracefully,” she adds.
Enter facial balancing. The cosmetic procedure, which aims to enhance the overall harmony and balance of the facial features, has become a go-to service since it went viral in 2023. Initially driven by consumer demand for non-surgical, less invasive cosmetic alternatives, the trend has since exploded on TikTok. The #facialbalancing hashtag now boasts over 29,000 posts, many of them featuring dramatic before-and-after photos of everyday patients.
For many of her Black clients, however, Assebian notes that the biggest concerns are looking “overdone” and avoiding judgment from friends and family. To that, she reassures them that facial balancing isn’t about changing who you are. “It’s not to change your features or to have you look white, per se. It’s about enhancing what you have and aging with grace,” she says.
With facial balancing gaining steam across diverse beauty demographics, below, Assebian breaks down the need-to-knows, expectations, and other oft-overlooked FAQs for anyone considering the treatment.
What Facial Balancing Actually Is
Facial balancing takes a holistic approach to proportions rather than focusing on a single area. “It’s a custom facial aesthetic plan to adjust your facial proportion,” says Assebian. “We focus mostly on the features. We want the features to look more harmonious from all angles, without erasing your unique features. We often do it in stages for safety and for natural results.”
The treatment typically involves neuromodulators such as Botox, hyaluronic acid-based fillers to add structure and volume, and, for more mature clients, biostimulators like Sculptra to stimulate collagen. Once structure is in place, Assebian says that she may incorporate lasers to address pigmentation or fine lines, especially for clients with skin of color.
What To Expect During And After Treatment
Facial balancing usually takes place over multiple sessions. “Facial balancing can require around two to three sessions, depending on the baseline and what we’re starting with,” Assebian explains. “People will come back to me maybe every four to five months to redo the Botox. When it comes to the filler, filler is a hyaluronic acid-based product, so it’s a little longer lasting than neuromodulators. With that, maybe they will come every six months depending.”
Botox takes about two weeks to show full results, while filler provides instant gratification. “You’re going to notice the difference [with Botox] right away,” she says. “You’re going to be a little bit swollen, because again, the mechanism of action of hyaluronic acid—think of it like a sugar molecule. There’s an inflammatory reaction that occurs, so there’s going to be some swelling.”
She advises clients to expect peak swelling around 24 hours after the procedure, which then tapers down. Tenderness typically lasts two to three days. She recommends using ice packs to reduce inflammation and Tylenol to ease discomfort. Makeup should be avoided for the first 12 hours to prevent infection.
When it comes to pain, Assebian speaks from experience as both a provider and a client. “The pain will be mild to moderate,” she says. “If you had to put it on a scale, I would say maybe around a four maximum out of 10, and that’s even with some numbing. One of the most sensitive areas to inject are the lips.” For that reason, her practice offers a dental block to make the experience more comfortable for those sensitive areas.
How To Prepare Before Your Appointment
Preparation begins at home. Assebian asks new clients to fill out forms that disclose health history, allergies, medications, and conditions like pregnancy or autoimmune issues. “That’s a must,” she says.
Clients should stop taking ibuprofen, Naproxen, Motrin, fish oil, omega-3s, vitamin E, garlic, ginkgo biloba, and even some types of green tea at least four to five days before the procedure, since these can thin the blood and increase bruising. She also advises avoiding major dental work for two weeks before and after the appointment to give the filler time to settle.
Skin prep matters, too. “You want to stop any sort of aggressive or harsh chemical, like strong retinoids, retinol, AHAs and BHAs,” she says. “Fresh chemical peels that’s abrasive on the skin, scrubs, and benzoyl peroxide should be avoided, too. You want to stop those actives for about four to five days before your treatment to keep the skin calm.”
She also encourages clients to bring makeup-free photos from different angles and reference photos of their desired results. “I’m not saying that you’re going to look exactly like [the photo], but just for pure client satisfaction, it’s very important to come into the office with these pictures,” she explains.
The Right Questions To Ask Your Injector
Assebian emphasizes the importance of safety and transparency. Clients should feel empowered to ask what products are being used and why. “You want to know what’s going to be injected in your face, especially if you’ve never had injectables before,” she says.
She also recommends asking whether the provider has hyaluronidase (the dissolving agent) on hand in case of emergencies, what techniques they use to minimize risks, and how they handle follow-ups and touch-ups. “A safe injector always has the hyaluronidase on deck,” she says.
Special Considerations For Black Skin
Because darker skin tones can react differently to trauma and bruising, post-care is especially important. Assebian recommends using SPF 30 to 50 starting on day two, along with a gentle brightening regimen like vitamin C to help even out any discoloration at injection sites. If bruising lingers, she says that she sometimes follows up with light therapy or lasers to help clear it.
How Much It Costs
Facial balancing is an investment, especially in New York City. “You need to have a minimum of $2,000,” says Assebian. “On average, your filler syringe is going to cost about $850 to $1,000 per syringe, and then your Botox is going to be around $700 to $1,000.”
She also notes that one syringe doesn’t go as far as many people think. “People have this conception that filler is going to make them look puffy. Maybe one syringe is enough, but you have to understand that one syringe is a blueberry in terms of amount. Imagine the provider trying to stretch a blueberry around your cheeks and your chin,” she says. “That’s why it’s important to have a consultation and talk budget before you proceed.”
The Bottom Line
For Assebian, facial balancing isn’t about creating a new face—it’s about refining and preserving the one you already love. By approaching it with the right preparation, realistic expectations, and a trusted provider, Black women can use injectables as a tool to enhance their natural beauty without losing their unique features.