I'm not sure what I should do about my protruding mouth area and hollowing of my mid face. Any suggestions? (photo)

Question

I I have been noticing since the past year that my mouth area seems to protrude. It also seems that my mid face area is hollowing and I'm only 24! I have been a regular moderate to high intensity exerciser for the past 5 years, eat healthy, take care of my skin and my appearance. I don't know why all of a sudden my face has changed and I look so much older than I am. What do you think is happening and what would you recommended to fix the problem in terms of fillers or other cosmetic procedures?

Guy Watts, MBBS (Hons), FRACS (Plast) · Answer

Thank you for your question and images. It would be useful to see a side profile view to look at the aesthetic of the lower third of your face compared to the upper two thirds. The the perioral area can be influenced by the inclination of the underlying dentition. If your dentition is proclined (inclined forward) this can give the appearance of fullness around the lips. You should also have your occlusion assessed, the way the upper and lower teeth come together. This can also influence the appearance around the mouth but may also indicate the potential for jaw surgery which is a powerful means to alter the appearance of the lower third of the face. Weight loss overtime and various dieting regimes can result in facial fat atrophy. Although this can be beneficial for defining the bony structures of the face, overtime it may transition to a more gaunt appearance. The use of facial fillers, either synthetic or fat can aid in volume replacement.RegardsDr Guy Watts

Michelle R. Yagoda, MD · Answer

Dear Sarah,If you are concerned about changes in your mouth that occurred over the last year, you should see your dentist first, to evaluate your bite.  Teeth tend to shift in the 20's and 30's and sometimes this can be the underlying cause of aesthetic changes around the mouth.  Another factor can be extreme or sudden weight loss.  Absent these issues, you can chalk it up to genetics and camouflage the area with fillers.  A little filler in the top of the nasolabial folds (to bring forward the area under the nose) and a little in the crease of the chin (to bring forward the area under your lip) can balance out the entire mouth area and give you the look  you are searching for. Best of luck,Dr. Michelle Yagoda

Michele S. Green, MD · Answer

There are any number of facial fillers that can be used effectively to fill in the facial hollows.  For many patients Sculptra is preferable but takes several treatments to build collagen but results last up to two years.  Juvederm Voluma gives you an instant lift which my patients LOVE!! Please consult a board certified dermatologist  experienced with these injections.

Alexandra Chambers, MD, PhD · Answer

Thank you for your question and photograph.It looks as you might have mid-malar (middle of the cheek) and buccal (side cheeks) fat compartments volume deflation. Because of that your naso-labial triangle looks more pronounced as the surrounding tissues are scarcer.This often seen in people who lose weight. Older people (not your age group) can have facial fat compartments deflation and sagging due to gravitational forces.Some medication like anti-HIV can cause this as well.Dermal fillers, Sculptra injections or own fat transfer are all used to re-balance facial volumes.

I'm not sure what I should do about my protruding mouth area and hollowing of my mid face. Any suggestions? (photo)

Answers (4)

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