28 y/o concerned about lower face buccal tissue, dimples, and jowls. What can I do to target this area? (photo)

Question

I’m 28, and my lower face has always been a huge insecurity. I’ve always had more buccal tissue, excessive dimples, and genetic “jowls.” I posted a few pictures that really highlight it. I’m not sure what can be done, my budget is $8k. I have tried doing very simple filler in the high cheek area 4 years ago to “lift” the lower face, but it didn’t work well. What else can I do? I’m located in Alaska so would need to travel.

Nelson Lee Novick, MD · Answer

Unfortunately, the one photo provided shot at a distance makes it difficult to assess the issues properly. However, from what can be seen there are smile lines, some loss of definition of the jawline and incipient marionette liness--all of which are quite common issues in any active cosmetic dermatology practice and all of which can be easily addressed with an appropriate choice of HA filler suited to the individual area and when performed by an experienced injector. All areas can easily be done in one treatment session of tops about half an hour, so, if you have to travel for treatment, this would make it much more convenient. Just make sure to consult with an experienced board certified cosmetic dermatologist. Best of luck.

Jason Emer, MD · Answer

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.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. You may benefit from a combination of dermal filler and microneedling treatments to address the areas of concern you’re referring to. Though you’ve previously had unsatisfactory results with filler administered to the upper cheek, more strategic placement can target lines around the mouth to create a smooth appearance. 
RF microneedling can also smooth lines while tightening the skin by increasing the body’s natural collagen and elastin production. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector. They will be able to assess your concerns and suggest the best course of action to help you achieve your aesthetic goals.

Jeffrey H. Spiegel, MD · Answer

You have a common concern and common request.  We can likely reduce the buccal fat and then do a small skin tightening procedure called accutite, both right in the office. This should tighten that area straight away and really help.

Darryl J. Blinski, MD · Answer

Based on the "1" posted photo I recommend mini face/neck lift with SMAS plication, HA filler x4 syringes to face areas @ a fee $8,000. Best to virtual consult with…

28 y/o concerned about lower face buccal tissue, dimples, and jowls. What can I do to target this area? (photo)

Answers (5)

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