Help! Entire lower face has changed shape (wide/sagging jawline), what can I do? (Photos)

Hello and thank you for your question! Based on your photos, I think you would be a great candidate for Facetite or Accutite. Both procedures emit radio frequency energy on the underside of the skin to melt fat and stimulate the skin to tighten, remove fat via liposuction, and tighten skin from the superficial layers with micro-needling or Morpheus 8. Facetite treats the lower part of the face, underneath the chin and upper part of the neck. Accutite has a smaller hand piece that can better target smaller areas like the jowls and the submental area under the chin. I recommend you have an in-person consultation to determine if you are a candidate and which procedure would be best for you. Good luck!

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.

Hi,

Thank you for your question and photos. The lower face (jawline, jowls, marionette lines, chin), and neck area, in my opinion, are the most challenging areas to treat as the results are not always satisfactory and may not meet your expectations. The reason for this is that the aging process (bone and fat absorption, reduction of collagen, and skin elasticity) also affects the upper and mid-face: temporal area, cheek, and mid-face. This aging process starts around 30 years old.

My approach always involves a detailed assessment of the face and neck as a whole unit to identify the aging trigger points and understand which areas of the face need to be prioritized and treated to restore the lost volume and achieve a lifting and natural-looking effect. In my opinion, and based on my experience, I don't think you are suitable for a neck/face surgical lift yet. Instead, you could be suitable for a less invasive approach, which involves the combination of fillers on the upper, middle, and lower face (in specific areas) to give structure and support to the lower face. After a few weeks, a Radiofrequency procedure (i.e., Face/Necktite and Morpheus 8 or Renuvion/J plasma) can be performed for tissue contraction (fat and skin tightening) on the lower face (jawline, jowls, marionette lines). Morpheus 8 requires three sessions (4 to 6 weeks apart). It can be quite uncomfortable; for this reason, in my clinic, the procedure can be performed awake with local anesthesia.
I would advise you to schedule a consultation with a surgeon who is an expert in facial contouring and and skin tightening treatments for a medical assessment in order to create a personalized treatment plan.
All the Best,
Dr. Giuseppe Fiore

I have been injecting fillers for well over three decades with extremely gratifying results for achieving all kinds of nonsurgical filler facelifts.. At least from the photos provided there do not appear to be any kind sof issues that would not be amenable to the use of appropriately robust HA fillers injected in the proper areas in the appropriate way in an adequate amounts. Boluses of a robust HA filler, for example, in the upper outer cheeks would help not only to create a more heart-shaped, oval ,feminine facial contour, but would help to soften the incipient smile lines below and likely, to some extent, straighten the down-turned corners of the mouth. A robust HA lifting filler directly injected in the region of angles of the mouth would result in further improvement. And, although a profile view was not provided, it is likely that a robust HA volumizing filler injected in the region of the angle of the mandible and along the jawline would go a long way to strairghenting and defining these areas and makie the jawline appear less saggy and jowly. Now, if only one or two syringes of ordinary Juvederm or plain Restylane had been injected by an inexperienced medspa type injector, for example, then the disappointment you obvisously experienced would hardly be surprising. Instead of jumping to some expensive "bells and whistles" gizmo, like an RF device, whose hard science to support its use lags woefully behind the heavy marketing and social media hype to promote it, you would be wise to make sure you consult with an experienced, board certified cosmetic dermatologist injector and be sure to ask to see his/her personal befores and afters before agreeing to proceed. Hope this helps and best of luck.

Dear Peaceful574854, This is a very common complaint from patients as it is the natural way the face ages. There are other treatment options that you can try before going to the extremes of a neck lift which has significant risks and downtime. Cheek filler is great for revolumizing the upper face. As we age, volume is lost and the skin begins to sag. If you did not notice any improvement it may be that you just need a bit more, or it needed to be placed differently. For you, filler in the posterior face and chin will give you a more rejuvenated look while adding structure to your face. Combining filler with strong PDO threads, like the Mint 43s or Mint Easy, should give you a nice result. It would beneficial to add some form of radiofrequency treatment like Morpheus 8 or FaceTite. For you I think the combination of both would be great, and the Morpheus 8 will have an added benefit of improving tone and texture. Hope that helps!

Hello Peaceful574854,
You do look like a great candidate for Morpheus 8. After 30 our bodies stop producing collagen, which leads to our skin sagging, and fine lines. Morpheus 8 is radio frequency micro needling, which helps to stimulate collagen production. 3-6 sessions of Morpheus 4 weeks apart should make a dramatic improvement to your problem area.

From your photos it appears you will have the best results from a combination of treatments. Botox to the masseter muscles can help to slim the jawline. FaceTite can help to sculpt the jawline and improve contours. Morpheus8 treatments can enhance the results by addressing skin tone and texture. See an experienced provider for a consultation to learn more.

Your cheeks are starting to atrophy and you are developing jowls. This is a common sign of aging where you go from a heart shaped to a rectangular shaped face. Consider dermal filler injections to your lateral cheeks to help pull up the lower face and widen your mid face. Then consider Kybella injections to your marionettes and jowls to narrow your lower face. Botox to your masseter muscles can also narrow the lower face. You need a very skilled injector to do this.