Flat Cheeks and Slight Jowls --will Fillers Be Enough? (photo)

My face seems to have lost lots of volume since last October and I'm noticing slight jowls as well as flattened lower face, the fact I'm losing weight isn't helping. I don't have the downtime required for a facelift (don't think I need it yet), but I'd like to ask: 1.Would fillers be enough to correct these issues? (I'm no stranger to them), if so which one and where should it be injected? I think more volume on cheeks might camouflage the jowls? 2. Would a laser/peel be better? Thanks!

Doctor Answers 27

Fillers for early aging changes

You are an excellent candidate for improving facial contours and hiding early signs of aging with injectable fillers.

I would definitely treat your cheeks and jawline.

Juvéderm is an excellent choice – in my hands, I find it does just as well when used in proper amounts as harder, stiffer, less predictable fillers.

The laser would be good for improving skin texture, but for your shape changes, fillers are best.

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 198 reviews

Flat Cheeks and Slight Jowls --will Fillers Be Enough?

Based on your photos provided, your best option would be applying Radiesse to build volume and contour the cheek until your ready for a facelift. I suggest seeing a certified physician who can provide the results you wish to achieve.

Best of luck 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews


Yes, fillers could help.  Injecting some in your malar area could help restore a youthful shape to your mid face and also subtly decrease the severity of your NL folds.  Some filler in your jowl area could also help until you choose to have a facelift.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Fillers for Flat Cheeks

Fillers are the ideal solution for you. Radiesse is the filler I would recommend. It is made from calcium hydroxylapatite--a substance found within our bones--and is a major building block of collagen. It works for non-surgical facial lifting and contouring by forming a sort of scaffold under the skin for new collagen to build on. It has a thicker consistency than hyaluronic acid fillers and lasts approximately 12 to 18 months.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 32 reviews

The 3D Vectoring Facelift Works Well For Flattened Cheeks, Facial Sagging, & Early Jowls

A vector describes a magnitude and direction of force. Aging skin is characterized by a negative downward and inward vector of sagging. To counter this, surgeons traditionally pulled skin upward and outward--i.e. using a positive vector. The key difference between the outcomes of traditional surgical correction and nonsurgical 3D vectoring, both of which lift upwards and outwards, is the Nonsurgical 3D Vectoring Lift's additional corrective dimension of ‘forward projection’. This 3D effect is the result of volumizing with the use of injectable agents designed for this purpose, such as Radiesse, Voluma, Restylane SQ, and Stylage XXL. Ordinary fillers do not provide the necessary lift or longevity.

The Nonsurgical 3D Vectoring Lift is predicated upon the fact that the face and portions of the neck differ in their degree of mobility. The region directly in front and behind the ears is a fixed, denser, relatively immobile area, in contrast to the mid-cheek region (hence the greater tendency of this region to sag with the passage of time). These anatomical differences are exploited in the Nonsurgical 3D Vectoring Lift by making the fixed areas serve as anchoring points for the mobile tissues. 

In determining the positive vectors for the mid to lower face, the tissues that require lifting are identified by pulling the skin directly in front of the ears in a direction perpendicular to the area that requires correction. If the pulling results in lifting of the desired tissue, then the vector has been correctly identified and is then marked in accordance with 3D vectoring protocol. A similar approach is used in the region of the angle of the jaw or in back of the ear when dealing with neck laxity.

Once the proper vectors are marked, the volumizing agents are injected in a series of radiating bands that serve as support struts to the skin and that impart the necessary 3D outward projection--the lift--that distinguishes and defines this nonsurgical approach. The high viscosity and elasticity of the volumizing fillers serves to hold and re-support the overlying tissue and restore more youthful contours.

Although volumizing fillers are reabsorbed over time, they do promote new, native collagen synthesis, which may continue to provide structure, firmness and improved skin quality while continuing to lift tissues. A typical Nonsurgical 3D Vectoring Lift of the face takes about fifteen minutes to perform. Bruising and swelling tend to be minimal, and most people can return to work or social activities immediately following treatment.

Naturally you should consult with a board certified aesthetic physician who is experienced with this technique.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

Flat Cheeks and jowls, Will fillers be enough?

Looking at your photo, I think some fillers in your mid face Would definitely help. Without seeing you in person it's hard to know how much, but estimate 2 syringes of Radiesse, Juvederm, or Perlane to start. This should be done before a surgical procedure is considered.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Fillers For Flat Cheeks

A lot of times, fillers is all that is needed to lift and fill the upper part of face or cheeks. It's a great idea to visit an experienced dermatologist so that you can be assessed in person.

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 17 reviews

Flat Cheeks and Slight Jowls --will Fillers Be Enough?

 Aesthetically speaking, from the photos provided, the anterior (front) portion, of the cheeks, should be augmented as the rest appear to be properly shaped for a soft, feminine face.  I prefer using Perlane to augment the cheeks and the Marrionette Lines (in front of the Jowls).  Start with the Perlane to shape the cheeks and then if you'd like more of an improvement the next step would be a minimal incision Face Lift to remove excess skin and tighten the facial tissues.  Be sure that the plastic and cosmetic surgeon, you select, for both understands and follows the proper aesthetics of facial (and cheek) beauty for the creation of a naturally more attractive, feminine face.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Fillers and Sculptra ideal for flat cheeks and slight jowling

Sculptra might well be the best primary option here if you willing to be a bit patient.
Sculptra results are long lasting and look completely natural since the "fill" will be your own collagen.
If instant is your requirement, then Radiesse can enhance the cheeks and you could augment with a hyaluronic gel in areas that require a softer feel.
Are you losing weight on purpose? Any unintended weight loss could be a signal that you need a medical checkup. If your intent is to lose weight, then facial volume always tends to be affected along with body weight loss.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 21 reviews

Fat Transfer or Filler

As we age we all start to lose structure, and although weight loss can be a good thing, it can make the face look like it's "falling". Fat transfer or lipostructure would be a good option for you because it offers much more material to inject in the face and lasts much longer than a hyaluronic acid filler (Juvaderm, restylane, perlane, ect...). A small amount of fat is removed from the abdomen, then after being centrifuged, is reinjected into the face. Sometimes we will inject 15 more cc's of fat back into the face at once. It can help minimize the jowling and add youthful structure. The downtime is 2-3 days with some mild swelling and bruising. Otherwise, if you are more comfortable with fillers, they can help, but you would need several syringes (cc's). And remember the body breaks down fillers within a year, unlike fat that can potentially last 7-10 years.

Lee P. Laris, DO
Phoenix Dermatologist
4.8 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.