Which procedure do I need for a very heavy looking lower face especially around mouth?

I am 29 year old female.Genetically,my cheeks look fallen and collected in my lower face around mouth.It gives a sad look all the time.when i smile little bit ,it slims down my lower face and raises my upper cheeks and that is what i want permanently.How is that possible. thankyou.

Doctor Answers 3

Heavy lower face

It is difficult to recommend a specific treatment or procedure without pictures, but what you are describing is a very common change as we age, and can happen in some individuals sooner than others.  Restoring volume to the upper cheek, facelifting, and lower blepharoplasty are all treatments designed to help with aging changes in this region.  Given your age, I would suggest looking into some volume enhancement to the upper cheek such as Voluma or even an implant if severe deficiency is noted.  But again, a good examination and consultation would be needed to say for sure.   Good luck.


Omaha Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Which procedure do I need for a very heavy looking lower face especially around mouth?

Genetic heaviness of the lower face can be difficult to treat.  However the basic esthetics still hold true.  We generally need the shape of an inverted egg when viewed from the front.  This can be accomplished by adding volume wither with fat transfer which I prefer, or decreasing the heaviness of the lower face, such as with neck or jowl suction.   Fillers can assist but are usually temporary and so I use Bellafill for a more permanent change is fat transfer is not an option.  The hollow in the face can be enhanced with strategic suctioning, but should only be done by a very experienced lipo doctor. Good luck.Dr. Seare

William J. Seare, MD
Carlsbad Plastic Surgeon
5.0 out of 5 stars 16 reviews

Which procedure do I need for a very heavy looking lower face especially around mouth?

Hi, I have performed many facial shaping procedures using dermal fillers, facial implants, liposuction and/or facelifts for over 30 years.  Non smiling photos of your face from the front and side would help in the evaluation.  I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties that had early formation of "jowls".  
 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.

If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS 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, deep plane, cheek lift 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 Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 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.