44, weight loss, will Botox & filler purchase help sagging & sides of mouth issues? (Photos)

Question

Lost 60 lbs and look so much older. Par for the course but I want to be better for myself. 44 years old, I have done Botox on frown lines, crows feet and forehead. I bought the expensive filler (one syringe) and 30 units of Botox to "sprinkle" Is the purchase going to even help? I have an appt coming up soon. No consult but would like to go in prepared and educated..

Timothy Osborn, MD · Answer

You do need to be careful when using Botox around the mouth because it can effect your ability to smile /make expressions if it is misplaced. I would recommend skin tightening treatments, such as RF (radiofrequency) microneedling. This can be used on your face and neck to improve overall skin laxity and reduce the small pouches around your mouth. Filler can be used to treat volume loss but can also make features appear overfilled, so there is a fine line between just enough and too much.

Nelson Lee Novick, MD · Answer

First off, let me say that buying a syringe and some units of Botox is not the most efficient and effective way to go about facial rejuvenation. I generally spend 1.5 hours in a first consultation with every new patient seeking facial rejuvenation to better define the problems that bother them and to tailor a specific treatment plan for each problem and then to clearly state what fillers and neuromodulators and how much of each are necessary to achieve the person's specific goals. It would be unthinkable to me to have a person purchase a few units of this and a syringe of that and then proceed with a "Let's see if we can do anything for you with what you just bought" approach. My guess is that you will likely be disappointed with what you were just sold. Sorry. 
At least from what I can see in the photos, you might profit from the use of a robust HA volumizing filler for a nonsurgical cheek augmentation. Properly performed by an experienced, board certified cosmetic dermatologist filler expert not only will be the cheeks be improved, but likely the smile lines diminished and even to some extent the jowls and drooping to the sides of the mouth improved. If necessary, a robust HA lifting filler can then further address both the smile and marionette lines. While Botox is sometimes used for the muscles that create the folds to the sides of the mouth, I find fillers work much better for this. I hope this helps and best of luck. Make sure that you are consulting with an experienced, board certified cosmetic dermatologist injector expert. Hope this helps and best of luck

Alex Cheah, MD · Answer

Hey there! Great question - unfortunately, botox and filler are unlikely to bring about the change that you're looking for - particularly not botox. Filler can be used in that "region" to camouflage what you're seeing. Specifically, placing it below the corner of the mouth can help upturn it somewhat, giving a more youthful appearance, as well as above in the nasolabial folds. However, the perioral mounds and skin laxity you're seeing would better be served with either energy based devices i.e. RF or surgical options like a facelift. Hope that helps!

Camille Cash, MD · Answer

One syringe of filler isn't going to make much of a difference, especially if spreading it over several areas.  I encourage you to begin by visiting with an expert injector to discuss your concerns and treatment goals.  Together you can come up with a plan to help you achieve them.

44, weight loss, will Botox & filler purchase help sagging & sides of mouth issues? (Photos)

Answers (4)

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