Marionette and cheek hollows. Any suggestions?
Doctor Answers 7
Marionette and cheek hollow
How can I get facial improvement without fillers?
Facial Sculpting Using Fillers Like Voluma, Radiesse, Lyft, Juvederm and Sculptra and Fat
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Have tried juvaderm ultra and radiesse in upper cheekbones and apples to pull up lower face about 25 times with no luck.
Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. Marionette lines are the lines formed by "Jowls".
My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
- very small incisions
- minimal tissue dissection = less bruising and swelling = rapid recovery
- can be performed in 90 minutes or less, with or without general anesthesia
- no incisions within the hair = no hair loss
- excess fat can be removed
- excess skin removed
- cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
- most patients fly back home to parts all over the world in as little as 3 days post-op
Hope this helps.
Laxity and aging around the mouth and jawline, jowls
You will obtain your best result by a facelift and neck lift and judicious (not excessive) use of filler.
The face is a package so it must be balanced.
Addressing marionette lines and cheek hollows.
Using a combination of treatments conservatively is a better solution than blasting away with one treatment. Restylane Lyft or Voluma in the midface can project the cheek and recruit skin in the lower face. Restylane and Juvederm used directly under nasolabial folds and marionette lines improve contours focally. Skin care and resurfacing improves the quality and tone of the overlying skin.
There is a limit of what injectables can do. Surgical rejuvenation options, including fat transfer, should be discussed with your surgeon at your next consultation. Don't get overwhelmed by all of the options. Take your time, move forward conservatively. Safety is the priority.