Hi Sexyslew69,Your question is good, but the choice of your answers is not good. If not A, then my only choice is B? I apologize for this long response in advance. Short answers are good for getting to the recommendation (the sales part), but not great educating anyone. Does making a recommendation based on little to no information make me an internet expert anyone would want to see in person or just someone answering a certain number of daily questions as part of my marketing plan. Since I see flaws in many of the answers, I feel compelled to answer your question today, since I think that maybe I can help you not make a bad choice. If so then I did a good deed for the day (I’m on vacation in Taipei before the school year starts and I’m jet lagged.)Let me take you through my thought process. Choice A of filling the temples seems to be a reasonable choice which will make the temples blend more smoothly into the cheekbones. But I agree that it will not have any effect on the jawline. But I don’t agree with recommending a mini-facelift an irregular jawline, just as a browlift would do very little for fat loss of the temple May I ask how you may have developed this temple and facial fat loss other than natural aging? Have you had any significant weight loss of more than 5 lbs recently which can cause the face to become thinner through shrinkage of the individual fat cells of the face. Any medical problems (thyroid issues, etc)? Or did you do any non-surgical skin tightening like ultrasound or radio frequency which has the potential of shrink the fat cells (think microwaving a stick of butter). Although the method of skin tightening is causing thermal (heat) injury or coagulation with microneedling RF (cooking) resulting in a healing response which is shown under the microscope to increase collagen in the skin layers, but what about the collateral damage to the fat?In my practice, I ask for younger photos for comparison of what you used to look like and to determine what actually changed, to figure out what are the best treatments to try to reverse those changes. One example which is reversible fat loss is using Latisse or even some over the counter lash enhancers which have ingredients which causes PAP (Prostaglandin Associated Periorbitopathy) which causes the fat around and behind the eyes to shrink. If the enhancer is stopped early, most of the fat loss is reversible. If stopped after months of years of use, at least some of the fat can recover, but probably not all of it. If I can find something reversible, then I may not get to schedule a mini-facelift, but did I do the right thing (I hope so.) What if I booked the mini-facelift and there was a reversible cause which did not involve a cutting procedure, then did I do the wrong thing?If I can figure out a reversible cause first, that would be my first treatment. If it is not reversible or if weight loss was the cause and they are not willing to even try to gain 2-3 lbs to see if their face will improve, then a different method in increase volume would be considered, such as fillers or fat grafting. But would it make any sense to recommend a cutting procedure such as a facelift, not knowing any of the previous information or knowing what you used to look like? Perhaps I would also recommend a mini-facelift after going through my algorithm, but highly unlikely, since it would not result in a softer look, but only stretch your remaining facial tissues tighter over your bone structure.Since I am also Asian and familiar with how Asian faces age, my guess is that your younger face did not show much bone structure and your face looked softer and less bony. A minifacelift may help the jawline (a little bit), but making your face look softer with correctly place volume in deeper anatomic areas instead of skin filler injection may solve the both issues (two birds/one stone). Applying energy to the face to tighten is a very weak version of a facelift, but may be worse than surgical facelift which uses cold steel, since it may inadvertently or advertently cook (under the chin or jowls) facial fat in order to make the technology work and make a person even more gaunt (spending money to lose volume.)In our field, as a face and necklift specialist to be successful, I should try to “book” as many face and necklift as possible which would make me “better” than my competitors. Right? … hmmm not so fast. So when you come in with an A vs B choice, if I don’t say too much, clearly A will not solve your jawline problem, you are already thinking you want choice B, so let me not get in your way, and simply just book the mini-facelift. That’s what sales people in clothing stores do, they help you make your own decison and try not to get in the way since they work on commission. By the time I finish writing this response, most likely you may already be on someone’s table about to have the mini. I see my role as a happiness facilitator. Facelifts do not make everyone happy, so doing as many as possible may result in inadvertently operating on few patients who thought it would make them happy, but didn’t know any better and chose the wrong thing to do. In general, it has a high “worth it rating” on RS, but please also look at the “not-worth it” to balance your expectations. As the physician, we should know better and try to figure out if my procedure will truly help you and make you happy. If no amount of procedure(s) will make you happy (think BDD in general not specific to you), it is in both our interests to figure that out before any procedures are attempted. If the patient wants to do a procedure which I don’t offer, I will help them find someone who does (someone else who will help to make them happy, which I facilitated.)My practice is definitely more boutique. If I were a sushi chef, I would rather have an omakase restaurant than a regular sushi restaurant with only 3 seatings per night. I get to talk with my clients and see their reactions to each bite and make sure they leave happy. I might be a better businessman making more money selling sushi deluxes, spicy tuna/California rolls including take out , not lifting a finger, but being the quality control person, but that’s usually not why they went into “it.”Thanks for listening. Time to get some more sleep. Take care from Taipei!Best,Dr. Yang
