What is the best procedure for a sagging lower face? (Photos)

Question

I've looked into Sculptra, fillers, neck botox, Radiesse, but I feel unsure about what to do. I feel insecure about my nasolabial folds and marionette lines as well as the sagging skin on my lower cheeks into my chin.

David Hansen, MD · Answer

`All you really need is a little micro lipo with Quantum/Morpheus to tighten the skin nicely and it is all under local for great results. Special is only $5000 for  quality work.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. It sounds like much of what you’re noticing in your lower face — the nasolabial folds, marionette lines, and mild sagging — could actually be improved by restoring volume higher up in the face. Your cheeks may appear a bit flat or deflated, which can make the lower face look heavier and deepen the folds around the mouth. In this case, cheek filler could be very beneficial. By adding subtle, strategic volume to the midface, cheek filler helps lift and support the lower facial tissues naturally, softening the appearance of lines and improving facial balance. This approach often gives a refreshed, more youthful contour without directly overfilling the lower face, providing a more natural result overall. I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

At least from the photos provided, there appears, in the profile view, to be lack of harmony between the projection of the the chin and that of the lips and nose. in such cases, the use of a robust HA volumizing filler can help to harmonize the projections of the chin, lips and nose, and, as a secondary benefit help to straighten and better define the jawline. If by doing so, the mental crease (the horizontal furrow between the lower lip and the chin) becomes accentuation, a robust HA lifting filler can be used to elevate and smooth it. 
And, finally, should it still be necessary (although I doubt that it will), Botox can be injected in small boluses along the jawline and along the upper neck to further straighten the jawline and diminish the appearance of sagging.
You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert and best of luck.

Anna Chacon, MD, FAAD · Answer

From your photos, it looks like your main concerns are mild laxity around the jawline and the deepening of your nasolabial folds and marionette lines — very common areas that tend to show early signs of facial aging.

For cases like yours, a combination approach often gives the most natural and long-lasting results:

Sculptra or Radiesse: Both are excellent options for restoring lost volume and stimulating collagen production, which gradually improves firmness and contours. Sculptra, in particular, works over time to enhance skin structure subtly and naturally.

Hyaluronic acid fillers: These can be used strategically to soften nasolabial folds and marionette lines, creating a more lifted appearance without overfilling.

Lower face and neck Botox (or “Nefertiti lift”): This can help relax the platysma muscle bands that pull the jawline downward, subtly tightening the area.

Skin tightening treatments (like radiofrequency or ultrasound): These help contract collagen and further lift mild sagging, often complementing filler-based treatments.

Every face ages differently, and the right plan depends on your anatomy and goals. It’s not always about adding volume — sometimes it’s about restoring balance and redefining contours gently.

Camille Cash, MD · Answer

There are a few options to address a sagging lower face.  Botox injected into the masseter muscle can address a hypertrophied muscle and slim the jawline.  Volux can be used to sculpt the jawline.  It is specifically designed for this purpose.  Other fillers can be used to help improve contours of the face.  Another option is Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture. Visit with an experienced injector near you to learn more.

Leonard Grossman, MD · Answer

First of all, there’s absolutely no sagging in your face whatsoever as you are too young to show any signs of aging. The shape of your face is determined by your genetics. If you’re not happy with the shape of your face, I would not use fillers to change it. You can’t change the facial shape using fat grafting. Personally, I don’t think you need to do this, but if this is something that bothers you a great deal then this is what I would consider. If using a pencil or a computer software, you can show how you want your face to look, I personally can re-create exactly the same in real life using fat grafting. I hope this helps and good luck. From New York City, Plastic Surgery

What is the best procedure for a sagging lower face? (Photos)

Answers (6)

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