Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years. Non smiling photos of your face from the front and side would help in the evaluation. In my experience, tissues sag off the cheeks creating nasolabial folds when there is inadequate cheek bone volume to support them. The more flat or concave the cheek bones are, in the front section of the cheeks, the greater these tissues sag and at an earlier age. As the facial tissues sag towards the nose and mouth the nasolabial folds and "jowls" are created. I have performed facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts. It's important to keep all of the "heavily marketed" non-invasive skin tightening procedures in the proper perspective. Non-invasive techniques typically shrink the skin several mm's. There are 25.4mm's in one inch. The minimally invasive facelift described below can remove 2 to 3 inches of skin which equals 50.8 to 76.4 mm's or up to 25 times the amount of loose skin provided by non invasive skin tightening techniques. That reality should always be front and center in the decision making for prospective facelift patients. It should also be noted that non invasive techniques have no ability to properly dissect, elevate, trim and re-suture the SMAS layer or precisely reduce excess fat below the skin making them one dimensional at best. Following my beauty principles, 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 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 and no incisions extend or are placed within the hair. minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned) 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 from the face and neck excess skin removed from the face and neck 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.