Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek implants, chin implants, lip implants), liposuction and/or facelifts for over 30 years. Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. Precise placement of the dermal filler is required to accomplish the heart-shaped face. Dermal fillers to the outsides of the cheeks will broaden and masculinize the face. Over-filling the lower face with fillers can make the face appear more round and chubby. Similarly, placing too much filler in the jaw line will also create a more masculine-looking face. These issues illustrate the need to seek out an experienced facial shaping surgeon who understands the aesthetics of facial beauty. Finally, there is no evidence of loose skin (tissue) in the lower face. Called "jowls" these are the main indication for any type of SMAS facelift procedure as described below. If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits: very small incisions and no incisions extend or are placed within the hair. minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned) can be performed in 90 minutes or less, with or without general anesthesia proper SMAS Imbrication technique no incisions within the hair = no hair loss excess fat can be removed from the face and neck excess skin removed from the face and neck cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants most patients fly back home to parts all over the world in as little as 3 days post-op I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Hope this helps.