What can I do to achieve facial balance? (Photo)

Question

(asian/white female, 22) Chin fillers have noticeably improved my side profile, however botox had resulted in a less defined jawline and made the skin in the area somewhat saggier. I feel that I have a weak jawline but am unsure of how to go about defining it (see last pic). I am also concerned about shadows under my mouth making my face appear droopy. Additionally, would I benefit from lip fillers to make the philtrum and midface appear shorter? How can I further achieve facial balance?

Nelson Lee Novick, MD · Answer

First, let's start by saying that perhaps you might be overcritical about your looks. However, simple, nonsurgical HA filler procedures to address your concerns could serve as the icing on the cake. An appropriately robust HA filler for the upper outer cheeks would not only create an overall more oval, heart-shaped appearance, but properly injected would likely diminish the incipient tear troughs and early bag formation seen.  Another robust HA filler injected along the jawline would serve to straighten and define it--addressing the concern about the slight sagging there. Finally, if still desired, a small amount of a low viscosity, cohesive HA filler can be used along the upper vermilion border of the lip to create greater definition and a slight upper lip lift. You would be wise to consult with a board certified cosmetic dermatologist and to be cautious not to go overboard about any venue that simply seems to be merely rubber-stamping all your requests  Best of luck.

Camille Cash, MD · Answer

Fillers are a great tool to define facial contours and add volume where needed.  They can be used to help shape and enhance the lips.  One of the nice benefits of fillers is that you can go slowly to build up to the look you are wanting.  See an experienced injector near you to discuss your concerns.

Jeffrey Lisiecki, MD · Answer

Being seen and evaluated in person is the best way to answer this question. Generally, better jawline definition could come from chin implants, fat grafting, and fillers, as well as skin tightening. Lip filler won't really make your philtrum or midface shorter--examination and discussion in person would help identify the basis for your concerns and come up with a plan.

Jason Emer, MD · Answer

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Daniel Barrett, MD · Answer

Dear Philosophical16649,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

What can I do to achieve facial balance? (Photo)

Answers (5)