Would temple filler fix my lower face sagging or should I consider a mini facelift? (photo)

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

While I appreciate your question, I don’t think either of the options you mention would be the best fit for you. Temple filler would add fullness to the upper face, but it wouldn’t have much effect at all on the lower face. And I don’t see significant sagging to warrant a surgical facelift at your age. Instead, I would likely suggest the use of fillers in the lower face to address mild signs of sagging and tighten up your facial contour. These treatments are done via injection and take just a few minutes to complete. Results can last many months before additional treatments are required. Make sure you work with a board-certified plastic surgeon who is also an expert injector to ensure an optimal outcome. 

Temporal filler is an excellent choice to diminish the temporal concavity and re-create the "triangle of beauty". Fat or filler can be used in this area. Unfortunately this will not have an effect on your lower face. 

I appreciate your concern, but it appears from your photograph that you are not ready for a mini facelift and fillers may be a better option. Consult with a board-certified plastic surgeon in your area to explore your best options. Good luck.

Hello! While a Temple filler will not address the lower portion of your face, once can use fillers to augment the face. There are also many non-surgical or minimally invasive procedures on the market to address and treat your concerns. It is difficult to give you specifics due to the angle in the photo. It is best to meet for an in person consultation to discuss all available options. Good luck!

Filler to fill in temple hollowing will have no effect on the lower face. A well done minilift would improve the minimal lower face laxity that you have, but it is of course a much bigger step. I would  consult with more than one surgeon and look carefully at before and after pictures of patients with similar changes to give you a more balanced opinion of what is achievable.

Temple filler will not improve lower face laxity. However, you have very little lower face laxity, so you may be a great candidate for temple filler, and a little filler on each side of your chin (prejowl filler). This can improve the contour of your face without surgery.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa

It is hard to tell from photos what you want the temporal lift to accomplish.  The photos how that your upper lids are pretty heavy so I suggest considering having an upper eyelid lift.  Very simple procedure can be done under local anesthesia.  Without seeing your jawline and neck I can’t give a recommendation for a facelift mini or otherwise.

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.  Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Temple fillers will not lift the lower face. However, you might do very well with radiofrequency skin tightening treatments like Secret, a noninvasive treatment, or with ThermiTight, a minimally invasive treatment. I would suggest meeting with a board certified plastic surgeon and discussing your concerns and options.