My face looks so square and bottom heavy. What treatment would you recommend; Facelift? Fillers? (photos)

Thank you for your question and for the photos. In my professional opinion, there is no laxity of the neck and lower face; I can notice some degree of hypertrophy of the masseter muscle, which is your case is responsible for the "square" jaw.  Your nasolabial folds are minimal and I would not suggest any treatment for them.I would advice a non surgical treatment called "botox jaw reduction", consisting in the injection of botulinum toxin in the masseter.It is very, very effective in reducing the width of the lower face, softening the overall appearance and giving a more feminine look.I would not recommend anything else. I am sure you will be happy with the outcome.RegardsAndrea Marando

You have a wonderful jawlines and a pretty face. I would recommend facial fillers or fat grafting to improve the cheek and buccal area in order to soften square looking jawlines.

The picture demonstrates a strong skeleton an attractive features. I would limit any therapy to fillers in the marionette region. You are certainly not ready for a facelift.

A good exam is always necessary to determine possible alternatives and a good discussion is required to learn the expected results and the pros and cons of various treatments. In general if one has a heavier lower face and that is due to aging with skin looseness, usually the two options are either lifting to reduce the heaviness of the lower face or adding filler or volume of some sort to the cheek region to restore balance of the face. Sometimes both are done. A consultation is required. If you have a good discussion with your surgeon you will have a good understanding of the various alternatives.

At 40 I would not recommend a facelift. You could see significant improvement in volume loss with a dermal filler such as Juvederm Voluma and Juvederm Ultra Plus. With regard to the "square" shape of your face, many people are candidates for Botox slimming of the masseter muscle which can significantly reduce the width of the lower part of the face and create a much more pleasing triangular or heart shaped facial appearance. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

I've seen many patients with this same issue.  Fillers and skin surgery are ways of helping but not the key answer.  Fundamentally you have a heavy jaw.  I've done hundreds of surgeries to address this.  The procedure is done with no visible scarring (all inside your mouth) and has excellent results.Best of luck.

Thank you for your question. It would be nice to compare images of yourself at a younger age with the ones that you have provided. That would aid in differentiating whether the current features that concern you are related to the underlying structure of your face or the ageing process. I would suspect that the former is the most likely and that you have had these facial features for most of your life. You do have strong bony facial features and many people would be jealous of them, they will continue to serve you well for many years and often slow down the ageing process. I do not agree that you look masculine but if you are interested in refining your jaw line you may want to try some serial injections of botox. Over time these can thin the muscles and refine your features. It is possible to thin the bones along the jaw line but I would suggest that you try botox first. You nasolabial folds are very subtly and would not push you to try filler but that option is also available. Best of luck!RegardsDr Guy Watts

As you age the soft tissues of your face descend and can make the face look more square. As these tissues descend further, they fall below the jawline and forms jowls. Descending tissue also leads to formation of the nasolabial fold and marionette lines. This is treated with a facelift.Your nasolabial folds are very subtle and would be considered mild. There is no jowling. I would stay away from a facelift and work on balancing your face. This can be done by restoring volume to the cheekbones (malar area). A dermal filler would do a very nice job. Consultation with your local surgeon will help you find which treatments are right for you. 

You have early facial aging combined with thin skin. I believe you would be most happy at this point with Voluma  done around the area of your cheeks and just below to create more volume. See inexperienced injector for this.

Thanks for the question and you look much much younger, I would suggest a buccal fat pad (incision in mouth takes out cheek fat to narrow face) and an aggresive facial laser resurfacing to give the skin a youthful look againGOOD LUCK