Lower face volume loss - how can this be treated? (Photo)

Question

Hi all! I have very deep ?marionette rolls. I have done 1 session of 7D hifu 6 weeks ago but have a big occasion coming up in 6 weeks and I'm wondering if there are any more immediate treatments that can just buffer a little; I don't expect full restoration! Thank you in advance for any assistance

Hung William Song, MD · Answer

With a 6 week time frame, you definitely do not want to do any surgery. Energy devices such as HIFU take months to see results and may not even address your issue. I think the perfect solution would be a Y_Lift procedure. This is where fillers are implanted onto the angle of your jaw to bring back your jawline. This should help reduce the rolling in the marionette area and also give you a snapped jawline. The results are instant and can last for years and there is very little down time so you can be all set for your occasion in 6 weeks.

Anna Chacon, MD, FAAD · Answer

What you’re describing sounds like marionette lines/labiomandibular folds, although the depth of these lines can be influenced by several things, including loss of lower-face volume, soft-tissue descent, the shape of the chin and jaw, and the natural anatomy of the area. They are not necessarily caused by volume loss alone.

Since you have an important occasion in about six weeks, you actually have enough time for a conservative treatment that gives an immediate improvement, provided the treatment is appropriate for your anatomy.

The option I would most commonly consider for relatively quick improvement is hyaluronic-acid (HA) filler. HA fillers can provide immediate volume and have been shown to improve marionette lines and overall lower-face appearance.

However, I would not necessarily put a large amount of filler directly into the deepest part of the line. The lower face is a three-dimensional structure, and sometimes restoring a small amount of structural support around the chin, prejowl area, or adjacent lower face produces a more natural result than simply filling the crease. Lower-face filler treatment is generally most effective when the overall facial proportions are considered rather than treating one line in isolation.

Your recent 7D HIFU treatment is also worth considering in the timing. HIFU is intended primarily for tissue tightening rather than immediate volume replacement, so I would not expect it to suddenly replace lost volume within the next few weeks. Since you are already six weeks out, I would assess the result before adding additional energy-based treatment.

For your upcoming event, I would favor a subtle, staged approach rather than trying to completely erase the folds. HA filler is attractive in this situation because the improvement is generally visible immediately, although some swelling or bruising can occur for several days and occasionally longer.

I would also avoid aggressive treatment immediately before the event. Ideally, any filler would be performed with several weeks of recovery time, allowing swelling to settle and providing an opportunity for a small adjustment if needed.

If the lines are primarily due to laxity rather than volume deficiency, filler alone may only partially improve them. In that situation, treatments aimed at tightening the skin or, for more significant laxity, surgical lifting may ultimately provide a more substantial correction.

So, with six weeks before your occasion, a conservative HA filler treatment is probably the most practical option for an immediate "buffering" effect, assuming an examination confirms that volume loss is contributing. The goal would be to soften the transition and restore some support, not to completely fill every crease or make the lower face look overfilled.

Camille Cash, MD · Answer

You may want to consider Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture.  This can be combined with fillers to give you a more complete result.  I've included a video I hope you find helpful.

Kenneth Brito, MD · Answer

The fastest way to address this concern is to use very low G’prime hyaluronic acid on those area. Care must be taken not to over do as it can lead to puffy look.
The underlying cause of this concern is not just volume loss but also a weakness in the skin integrity leading to dentition especially during muscle contraction (such as smiling). Unfortunately, this will eventually lead to deep wrinkles and can be permanent as we age. My preference is a combination of low G’prime hyaluronic acid and biostimulator to enhance your own collagen production without fear of appearing too puffy. Biostimulator together with skin resurfacing and regeneration can further enhance the outcome.

Nuket Eroglu, MD · Answer

Hello; In addition to Hi-Fu, for laugh lines on your face, folds on your cheeks and marionette lines; Lanluma can be applied for your cheeks. Lanluma, creates for a liquid face lifting effect and it is a PLA (Poly Lactic Acid) molecule. It tightens for your skin. It rejuvenates and lightens your lines too. It stimulates for a natural collagen. It is considered; as an anti-aging implementation. I think; you will be very pleased.

Darryl J. Blinski, MD · Answer

As seen in your series of post of photos, a interior, mini facelift with muscle plication would be the best response to give you. Non-invasive or even very minimally invasive techniques do not either work or last. Best of virtual consult with. Expect fees to be in the $10,000 ranges.

Leonard Grossman, MD · Answer

Number one, you should not do any more treatments using either radio frequency or ultrasound as they will destroy more fat in your face and you will look considerably older. Don’t look for a quick fix since it simply do not exist and can only hurt you. The best way to restore volume in the Face is with the use of your own fat. When fat grafting is done by an expert, the results are natural and practically permanent. I hope this helps in good luck from New York City plastic surgery.

Lower face volume loss - how can this be treated? (Photo)

Answers (7)

More Dermal Fillers Questions

How to get rid of Jowls? (Photo)

How long until filler is no longer moveable?

Do I need filler? (Photo)

I want to put dermal filler in or on top of my eyebrow to make my browbone protrude more than forehead. Would that work? (Photo)

35, male, I have this dent in my forehead & I’d like to know what caused it? (Photo)

Is there anything I can do about these jowls? (Photo)

WE SEND PRETTY
EMAILS