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

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.