Wanting advice on treatment. (photos)

I'm not sure what's happening here, but the corners of my mouth or lower part of my cheeks are sagging around my mouth. What is the best suited and least invasive treatment to make this look better? TIA

Doctor Answers 8

Corners of my mouth or lower part of my cheeks are sagging around my mouth.

 Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek implants, chin implants), liposuction and or facelifts for over 30 years.  From the photos your cheeks are flat in the front (the lack of cheek bone support allows fat and tissues to sag and drop), there is significant excess fat below the cheeks.  These combine to create the beginning of "jowls" and create an elongated oval shaped face.

 Following the beauty principles outlined in my book on face and body beauty, 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.  Liposuction can be added to reduce the excess fat for further shaping of the cheeks.

Hope this helps.


Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Volume loss

Hi rg88,With time, the corners of the mouth and volar cheeks do sag to create jowls.  The best-suited treatment for this is facelifting surgery.  However, this is of course invasive.  Treatments that can be used to make this area less saggy are Botox to the depressor muscles of the corners of the lower lip and fillers in this area.  A skin tightening treatment may also be beneficial and we have found that the most effective of these skin tightening treatments is ultherapy.  This is a noninvasive skin treatment that causes a degree of skin contraction.Best,Warwick Nettle

Advice on treatment

It seems that you are losing volume in your mid cheek.  A small amount of filler placed in your mid cheek will help to lift some of the sagging skin as well as some filler placed into the marionette line.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 426 reviews

Lip Augmentation

Thank you for your question. Lip augmentation through fillers can increase the size of your lips while surgical procedures can create a slightly raised effect. In addition, the volume injectable can increase the volume of your cheeks. I suggest you next consult in person with a board certified facial plastic surgeon. Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

Filler recommendations

Hello, and thanks for your question and photos. What you are seeing is loss of volume in your mid-face (i.e., cheeks), and this is resulting sagging that is accentuating the lines in your lower face. The best treatment, in my opinion, would be placement of a thicker hyaluronic acid filler such as Voluma in your upper cheeks to provide structure and help lift. In order to determine the best treatment plan for you, I recommend an in-person consultation with a well-trained dermatologist or plastic surgeon. Best of luck, Dr. Frucht.   

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Juvederm And Voluma

Thank you for your excellent question and for sharing your photographs.  Sorry that you are having some concerns about your facial appearance.  Based on your photos, you appear to have some volume loss around your mouth and likely in your cheek area as well.  Please consider use of injectable fillers such as Juvederm and Voluma.  Beautiful and natural results can be achieved.  Please be sure to see an expert injector for an in-person consultation to fully discuss your concerns and your goals and expectations in order to determine the best treatment plan.  Hope this helps and best wishes!

Wanting advice on treatment.

Thank you for your question and for sharing your photographs. I would recommend dermal filler placement into your cheeks to help lend support and restore volume and lift to your cheeks to reduce the sagging you are experiencing around the corners of your mouth.  Be sure to see a board certified plastic surgeon in consultation.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Facial Changes Associated with Aging

You could look at a picture of your younger self from a side and front view like the ones shown here. I'll bet that you see the the cheeks are somewhat flatter, less rounded than when you were younger. This is what is called Midface Volume Loss and occurs more in some families than others. It is less related to changes in body weight and more related to heredity ( ie how your relatives age). Think of the skin surface as a table cloth and the structures below( collagen, muscle and even bone) as the table. So the table gets smaller but the table cloth stays the same size! This makes the lower face droop in some people . You can address this with fillers such as radiesse, or juvederm or even volumna or sculptra. Hope that this helps,Dr Beverly Johnson 

Beverly Johnson, MD
Silver Spring Dermatologic Surgeon
4.9 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.