Do you recommend filler, Botox and anything else in order to help improve my face?

Question

Hello doctors, I'm almost 30 and am interested in getting filler in order to make my face look more feminine and younger. I was thinking of getting it in my cheeks and especially lips, as well as Botox in my lower jaw. I was also wondering what else you would recommend to enhance my appearance?

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. It appears you have a good idea of which areas of your face concern you and the best treatments for those areas. The only one I might add is a bit of filler in your nasal bridge to produce subtle improvement in your profile. I encourage you to schedule a consultation with an experienced, board-certified facial plastic surgeon for further assessment and a customized treatment plan that will meet your needs and goals best.

Jason Emer, MD · Answer

my females do botox, fillers to the cheeks, eyes, temples, jawline, chin, and lips typpically for contouring or full facial sculpting see my IGTV and youtube.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly) should be started now to prevent further aging and improve quality of the skin (see link).

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Michael A. Persky, MD · Answer

Hi Lexi,

I see that you wish to look younger.  You are fortunate that you already look half your age. On your front view the only feature aging your face is the slight hollowness under your eyes and slight asymmetry between the left and right sides of your face (completely normal).  On the 3/4 view it looks like you have early loss of volume in the pre-jowl area and marionette area.  On lateral view your nasal profile is strong, making your nose slightly smaller and increasing the angle of your nose-lip (slightly raising your nasal tip) would feminize your profile.  For your face, I would treat you with Sculptra Aesthetic to add natural volume where needed.  For your profile you would likely benefit from the injection of filler at the base of your nose to lift the tip, and possibly a little filler on your profile to camouflage your small dorsal hump (that is unless you wish to have a surgical rhinoplasty.). As with any aesthetic treatment it is essential that you choose your treating physician most carefully based on their skill, knowledge, experience, and natural artistic vision.  Good luck and be well.

Michael Persky, MD 
Encino, CA

Laurie A. Casas, MD, FACS · Answer

Thank you for your question.  We typically use Botox (also Dysport, Xeomin and Jeuveau) and filler in combination to create facial harmony and rejuvenate the face.  Filler can help restore volume that been lost over the years and Botox can help smooth out fine lines and wrinkles.  Our patients are the happiest with combination therapy!

Toby Mayer, MD · Answer

Rhinoplasty and mini browlift for Facial Femininization. These 2 surgeries would give you the most natural feminization and a more attractive face. They can be done separately or together. Make sure you see a very experienced FFS surgeon who can show you dozens of natural results of his work. Don’t rely on imaging!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Your listed areas all seem to be reasonable places to seek improvement but don't forget about the undereyes as well.

Bonnie Gasquet-Johnson, MD · Answer

If you have never had injectables before .. I would do things step by step. You look great for 30 anyhow. But, if you want more cheek volume and a slimmer jaw line, maybe do the cheek filler and botox to the masseter muscles first. Address lips after. Also - I always love a little brow shaping, and brow lift/crows feet botox treatment to wake the eyes a little. Full cheeks and a fresh look are always a youthful trait. You look great regardless! Best of luck :)

Cristyn Watkins, MD · Answer

Volume loss and laxity issues are the most common signs of aging. Threads can lift and tighten saggy tissue, especially around the jawline and marionette lines. They penetrate through deeper layers of tissue. This is not only going to improve your profile, but it is also going to stimulate collagen and give you cellular rejuvenation that filler cannot give. 
If you have fat pad loss in the cheeks, you will also want filler to lift the midline face as this causes dropping and laxity decrease in the lower face/jowls. Threads and filler can both prolong your youthful face. Neurotoxins, like Botox, can help relax your forehead muscle. Depending on how deep your lines are, and how much movement you would like, our MD and RN Aesthetic Injectors can give you a subtle, natural look without over treating and 'freezing' muscles if you do not prefer this.
However, to obtain the best results and outcome, we recommend a consultation with a Patient Care Coordinator and/or Maser Injector.

Johnson C. Lee, MD · Answer

Botox can be used to give you a more defined arch to your brow and also to reduce wrinkle formation when making facial expressions. Fillers can be used to accentuate your cheek bones and jawline as well as enhace your lips and chin. Fillers can also be used for a non-surgical nose job to smooth the bridge of your nose which will look great from profile view. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD 
Board-Certified Plastic Surgeon​

Matt Tahsini, MD · Answer

Hello and thank you for your question. I recommend seeing a reputable doctor for a consultation and you can plan what’s best for you. Your assessment of what you need is pretty accurate, I would choose which procedure is most important to you and start there. Best wishes.
Dr. T

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