Puberty is when the face is built.
In boys, testosterone and androgen signaling drive the broader jaw, larger mandible, heavier brow, stronger cheekbones, and more robust lower face.
In girls, estrogen shapes the softer female pattern: fuller lips, subcutaneous facial fat, softer jaw, smoother contours, and earlier bone maturation.
Aromatase deficiency, androgen insensitivity, delayed puberty, PCOS, and endocrine disorders all show the same thing: hormones sculpt the face. Genes set the blueprint, but hormones decide how much of it gets built.
So when a teenage girl is under-eating, losing her real cycle, and masking it with the pill (!), she is disrupting the exact endocrine window where her face and body are still being built.
Low fuel means lower thyroid, lower IGF-1, weaker ovarian signaling, higher cortisol, and poorer tissue building.
It changes the whole architecture really.
And yes, her face can reflect that for life. Filler and cosmetic industries are happy about it though.