Which procedure would help reveal a more defined, prominent facial structure? Should I consider botox or fillers? (photos)

Question

Hi, I’m not sure if Botox is right for me but I think my face is rounded out in my mid face/cheek area. i am looking for something that would help reveal more facial structure/tightening. I’m not sure if I could benefit from masseter/nasolabial injections. I guess I’m trying to see what direction I should go or if this would help.

Nima Shemirani, MD · Answer

Hi @jj77555. Thank you for sharing your photos. I recommend a combination of both botox and dermal fillers to help you define facial features along the jawline.

Best of luck,

Dr. Nima

Jaime Haidenberg, MD · Answer

Hello!20-30 plus units in each masseter muscle will help lengthen and soften your facial structure. Finding a knowledgeable injector who injects on a full time basis and is familiar with facial anatomy should be able to help you with your aesthetic journey. Best of luck!

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You may benefit from a liquid facelift to create a more defined facial structure. This treatment option uses a combination of dermal filler and Botox injections to fill and lift the face to provide a rejuvenated appearance. 
The most natural results are achieved by targeting the specific fat pockets that have lost volume, and elevating sagging skin where necessary. The results of a liquid facelift can last for up to a year or more, depending on the formulas used. I recommend scheduling an in-person consultation with an experienced, board-certified injector who can suggest the best approach to help you achieve your aesthetic goals.

Caner Kacmaz, MD · Answer

Thank you for your pictures. It is definitely too early to consider surgical options for your wrinkles at this time. I do recommend you Botox. It will block nerve impulses o the muscle that's responsible for expression lines. This treatment will help soften their appearance. I recommend you repeat this treatment every 4-5 months to maintain the best results. Botox will definitely reduce your deep brow furrows, smooth your crow's feet, minimize your frown lines and lessen your chin dimple. Good luck.

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Camille Cash, MD · Answer

A combination of Botox and fillers can help you define facial features along the jawline and improve symmetry.  Morpheus8 treatments can improve overall skin tone and texture.  See an experienced injector near you to learn more.

Milan Doshi, MS, MCh · Answer

Thank you, jj77555 for your question and photographs.
 Photographic evaluation is incomplete without personal examination to give a most appropriate answer
 However from the photographs, it seems that,
If you want a more structured and contoured look as we can observe from the picture and you also have a good forehead however we can lift the eyebrows a little to give a better appearance but for the frown areas and the wrinkles botox would be the ideal thing and for the eyebrows botox and fillers would be ideal and also hollowness is there but for face structuring, I think botox would not be a good choice but fillers as the nasolabial folds will get reduced automatically because there would be myomodulation and slight lift would be there and for the lower face for a more contoured jawline dermal fillers would be the best answer for this but if you are concerned about the projection of the masseter muscles then botox would be the ideal choice. So a combination of botox and dermal fillers will give you the best results.

Wish you an alluring look.

Dean P. Kane, MD, FACS · Answer

Dear jj77555, 
Thanks for sharing your photos. The concerns you describe are due to early laxity and facial tissue and skin descent from loss of collagen in aging. We are said to lose 1% collagen yearly after the age of 30 which the body will not naturally restore. Your skin is relaxing in a arc toward your nasolabial and marionette folds like a wave coming onto shore. This is creating a lower balanced and rounder face. The strategy is to lift back upwardly and tighten. There are ways to lift the tissues and restimulate collagen firming and tightening non-surgically. Consider:

Consult with a Board Certified Plastic Surgeon with interest, experience and facial rejuvenation minimally invasive skills. 
Consider botox to rebalance and elevate the brows and upper cheek
Sculptra to restimulate, tighten and firm the facial skin
Properly performed PDO or PLLA suture suspension, ie., ThreadLift of your facial features; a minimally invasive (no surgical incisions or scars) technique.

You do not appear to need a facelift at this time.

I hope this is helpful. All the best!

David M. Kowalczyk, MD, MBA, FACS · Answer

Hello! Thanks for your questions. Botox can be useful for wrinkles of the forehead and 11 lines in men to smooth the appearance. Fillers are a great option especially along the jaw, cheek, and chin. Radiesse is a great product to build those areas as it's placed deep on the bone. It stimulates collagen and can be quite nice in chiseling the jawline, for example. Chemical peels and various moisturizing products do wonders to increase skin quality and texture. I would seek consultation with a facial plastic surgeon who also has a Med Spa to see what options may be best for you. Hope that helps!

Rita Rakus, MBBS - Account Suspended · Answer

Hello and thank you for your question. It is always best to see you face to face for a consult to give a realistic idea of what would help achieve your goals best. Filler is a great way to add structure and definition but energy based devices are useful for tightening and lifting. It's best to see a trusted clinic and get their opinion on what would get you to where you'd like to be. I hope that helps answer your question. Always seek an experienced and qualified medical professional for these treatments. Very best wishes

Which procedure would help reveal a more defined, prominent facial structure? Should I consider botox or fillers? (photos)

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