Hi, based upon the attached photos and while a non-smiling photo is much better for evaluation of the face, there is evidence of "jowls", nasolabial folds and flat cheeks anteriorly. Flat cheeks can amke the face appear elongated. Cheek Augmentation, with a dermal filler (I prefer Perlane) at the time of the facelift, can shape the cheeks which will feminize the entire face. If you have "jowls" this is sagging facial tissues and an indication for some form of a 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 facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits: •very small incisions •minimal tissue dissection = less bruising and swelling = rapid recovery •can be performed in 90 minutes or less, with or without general anesthesia •no incisions within the hair = no hair loss •excess fat can be removed •excess skin removed •cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Perlane) or facial implants •most patients fly back home to parts all over the world in as little as 3 days post-op Hope this helps.