Age 26, what can I do to improve this shape face, I feel like it need more volume when neutral? (Photos)

Question

Im 26 and don't like how my face looks in neutral or smiling position. I feel like I'm neutral it needs more volume but when I smile there's too much volume? What can I do to make it look better in both positions? Im worried if I get filler or fat transfer then it'll look too big when I smile even though it'll look good in neutral position. Too much skin? I don't know. Help!

Mahmood Siddique, DO · Answer

Hi Brooke! 
It sounds like you're looking for a more balanced appearance, and that's totally understandable. There are a few options that can help you achieve the volume you feel you need without overdoing it when you smile. 
Dermal Fillers (Strategic Placement) Dermal fillers are often used to add volume to areas like the cheeks or jawline. With the right technique and placement, fillers can enhance your facial shape in a neutral expression, but avoid adding too much volume when you smile. It's all about precise placement in areas where you want more volume, like the mid-face or cheekbones, while avoiding areas that would lead to excess volume when smiling. Finding a skilled injector is key to getting this right!
2. Fat Transfer Another option is fat transfer, where fat is taken from another part of your body and injected into your face to restore volume. This can give you a more natural, longer-lasting result compared to fillers. Since it's your own fat, it blends naturally with the surrounding tissue, giving a more subtle look. Just like with fillers, the placement is important here too to avoid any excess volume when you smile.
3. Facial Exercises or Massage If you’re looking for non-invasive methods, facial exercises or massage techniques can help improve circulation and promote a natural plumpness in the face over time. While it’s a slower process, it could provide subtle improvements in overall facial volume.
4. Cheek ImplantsIf you’re looking for a more permanent solution, cheek implants might be an option to consider. They can provide lasting volume and structure, especially in the mid-face. This is a more invasive approach than fillers or fat transfer, but for some, it’s a great option.
5. Skin Tightening Treatments If you feel your skin has loosened or sagged over time, skin tightening treatments like Ultherapy or radiofrequency therapy might help lift and tighten the skin, improving the overall contour of your face and balancing the appearance between neutral and smiling expressions.
Key Considerations:No matter what route you choose, be sure to consult with an experienced professional who can assess your unique facial structure and discuss your goals. Moderation is key in these treatments, and working with the right expert will help you achieve subtle, natural-looking volume.
Hopefully, this helps guide you in the right direction! Best of luck.

Jason Emer, MD · Answer

Facial sculpting and contouring can be created with well-placed fillers (Voluma, Countour, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Michael A. Persky, MD · Answer

Good Day Brooko,

Keep smiling, it's the best form of plastic surgery!  If you get tired of smiling then I would treat you with Sculptra structural support deep on your facial bones under muscle.  With proper treatment from a Sculptra injecting expert physician you will not only correct your volume but add a "Sculptra Glow" to your skin.  This treatment would be excellent for you and the results are very natural.  No one but your expert injecting physician and you should know.  Choose your treating physician very carefully, Sculptra treatments are not a commodity.  Please feel free to contact me with any further questions or concerns.  Good luck and be well.

Michael Persky, MD
Encino, CA USA
Mi

Sara Salas, MD · Answer

It is important for your physician to check your anatomy and the way it looks in movement before doing any kind of procedure... You might be a good candidate to get facial harmonization with fillers, if you choose a good linseeds doctor you can get great results that won't make your face look to wide or fake.

Viktoryia Kazlouskaya, MD · Answer

Usually, patients start having some volume loss by their late 20s, which can change the shape of their face. One syringe of filler is a very small amount, so you should not worry about looking "overfilled." You would need way too much product to achieve that look!

In general, a patient may need one syringe of filler for each decade of age. So, at 26, adding 1-2-3 syringes of filler is usually appropriate. Additionally, Botox to the jawline has been proven to give a subtle elevation to the midface.

Again, a consultation in person would be much better than static photos, as they do not always reflect the situation. Let us know if we can be of further assistance.

Peter Andolina, DO · Answer

I don't think you should jump to a fat transfer as your first line treatment.  You are still very young and fat transfers are pretty permanent.  In your case I would definitely start with some filler to enahce your natural beauty.  I also do not think your skin is an issue either

Luis A. Perez, DO · Answer

Hi! You have a beautiful face, and smile. Your features are very elegant, at least on what I can see in the pictures. If not doing so already, try a good medical grade skincare line. Something like Alastin. You can do a chemical peel and even a laser or morpheus8 to resurface the skin and tighten it up a bit. If you really want to reshape portions of your face, you can always try filler, but you are right, you may inject too much and then your face could look fuller when you smile. Hope this helps. And always wear sunscreen!

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  Based on your resting facial photograph I do believe that you would be happy with an increase in volume in the midface.  You cheekbones are excellent its just inside between the cheekbone and the nose where you are lacking midface volume.  In my practice I would use Restylane lift or Voluma to add volume to the midface.  I do not think it will affect the smile appearance as long as filler is not placed on the cheekbones on the side.

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