Dr. Sheila Barbarino On How To Look Younger Without Looking Overdone, What Actually Works & The Treatments To Avoid

Dr. Sheila Barbarino, an oculofacial plastic surgeon in Austin, has a straightforward philosophy about cosmetic treatments: the goal is to make someone look like the best version of themselves, not like they had work done. In a conversation with the hosts of The Bossticks, she explains why the most common aesthetic mistakes come from treating isolated problem areas rather than supporting the entire structure of the face. The episode is a practical guide to what actually works, what to avoid, and how to think about aging and enhancement without overdoing it.

The Foundation Comes First

The single most important principle Barbarino emphasizes is that the face must be treated as a global structure. When a patient comes in complaining about their under-eye hollows or tear troughs, the instinct is often to inject filler directly into that area. Barbarino warns against this. “If they don't have a good foundation to start with and frame the eye, using the temples, the midface, the lower face, it's never gonna look good,” she says. Without support from the cheekbones and temples, filler placed directly under the eye can push the eye upward, making it look smaller and creating an unnatural appearance.