I Would Be Very Grateful for Advice on the Definition Loss/Sagging Sking Around my Mouth/jowl Area? (photo)

I feel is quite bad for my age of 35, and it started around aged 29. I've had fillers in various places, with varying degrees of success. Nose-to-mouth fillers did improve that area, but nothing has really improved the two little "pouches" of skin either side of my mouth. Fillers in my upper middle cheeks in March did help to sightly counteract the look, but I'm still unhappy with the overall look. Fillers in my marionette lines made me look like a hamster! Thank you for any advice you can give

Doctor Answers 5

Loss/Sagging Sking Around my Mouth/jowl Area

Putting fillers at the marionette lines does not address the underling problem which is the aging skin of loose tissue and sagging skin.

You are right that adding  fillers at the marionette lines can give appearance of a hamster.

I would like to suggest a facelift but not the traditional facelift. This can be done with Venus Freeze tightening Txs. Venus requires several treatments. It is non-invasive and feels like a hot stone massage.

The best treatment is probably the new treatment LazerLift. It will tighten the tissue and skin and improve the smile and marionette lines, sagging skin, wrinkles, scars and pores. In addition the Lazerlift can laser away unwanted fat to give you a younger look. The LazerLift can be done in 1 hour and has minimal downtime and pain and will be the best for neck and face rejuvenation.

Honolulu General Surgeon
4.3 out of 5 stars 6 reviews

I Would Be Very Grateful for Advice on the Definition Loss/Sagging Sking Around my Mouth/jowl Area?

Great series of posting photos. Maybe you should consider a mini facelift? But ONLY in person examinations can allow a more definitive response. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Facial issues

Thanks for the photos, but the photos could be better and an exam in person is essential.  Sometimes fillers can help, sometimes facial surgery can help.  It really is difficult to say from just the photos you posted.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Facial evaluation

There are lots of things here, you had lots of fillers with some or no significant satisfaction. I believe you need to sit with a plastic surgeon and fully discuss the aging process, what is bothering you and what is available. Looking at you pictures there are lots of issue that may or may not bother you. It all depend on what you want to achieve. Brow lift, mini facelift and fat grafting to the entire face.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Some Advice


I think you started with the correct product, however as you mention, its not always perfect. Often times for people like yourself a combination of treatments are the best option. 

If you came to me, I would suggest to look into the following

1) Radiofrequency Skin tightening - this is a method in which we can heat your skin under your chin, around your mouth and marionette lines and other areas where it appears loose. By heating the skin, the collagen realigns and you can get a significant skin tightening effect. I find that in people with young, healthy skin like yourself the change be be dramatic. The good thing, there is little to no downtown and minimal chance of complications (but there are some, so be sure to ask). There are other similar laser methods of this such as Titan by Cutera. All these basically tighten the skin with minimal downtime. 

2) Continued use of fillers. This will help refine the tightening and really give you the look you desire. 

3) Mini or Short Incision Facelift - Even at an early age, the only real way to get rid of the jowling and extra neck skin is a "face-lift." Personally, i dont think you are close to being there, but some young people do ask for it and it certainly works dramatically. However, i would start with other options first. 


I hope that helps. 

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 17 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.