My face always looks sad. What can I do? (photos)

Question

My face always looks sad. I am 35 years old. Many years ago i had some fat transferred to my nasolabial folds however i do not feel that it looks any better. If anything it may even look worse. My mouth always seems to have a downward turn too and when my face is resting It never looks attractive. Is there anything that I can do that is likely to help me? Also, soon I will undergo orthognathic surgery for an under developed lower jaw as per orthodontists recommendation.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. The downturning of your lips certainly contributes to the feeling that your face always looks sad. I suggest that you move forward with a consultation with a board certified facial plastic surgeon. In your in-person examination, you and your surgeon can explore the combination of lip augmentation with Voluma, which adds volume to the facial contours and your cheeks for a healthful and more youthful appearance.Best wishes,

Jason Emer, MD · Answer

My suggestion is an in person consultation with a laser and filler expert.  I suggest a combination of Botox, fillers (Restylane, Juvederm, Belotero)/Sculptra, or fat. See an expert. Best, Dr. Emer

Steve Laverson, MD, FACS · Answer

We humans are indeed sensitive to unspoken communication by facial expression, as are non-human species.  Wait until healed from orthognathic procedure(s), because your facial features will be changed.  If you're still frowning at rest, consider corner of lip lift, which will produce a more neutral expression, or, if you want, a subtle smile.

Nelson Castillo, MD · Answer

Thank you for your question and photograph.  Though nothing replaces an in-person examination and discussion of your goal results I would advocate for dermal filler placement into your cheeks and conservative placement of dermal filler into your lips to help add volume and improve the downturned appearance of your lips.  If filler alone does improve the corners of your mouth, Bbotox can be added later to help.  Hope this helps.

Michele S. Green, MD · Answer

A small amount of Botox can help turn the DAO's in the lower face and it is best to combine with a filler like Restylane Lyft.  Please consult a specilaist.  Best, Dr. Green

Praven Chetty, MD · Answer

Dear irdeto:

Looking at your photo, you would benefit from Botox injections as well as fillers to the area underneath the lower corners of your mouth.  Best wishes.

Steven F. Weiner, MD · Answer

This can be corrected using fillers and Botox. Supporting the corners of the lips with filler and relaxing the muscle that pulls down on the corners of the mouth.

Michelle Eagan, MD · Answer

Congratulations for asking this question. Many people don't realize there are subtle ways of looking more refreshed and pleasant.  Your jaw surgery will help with looking less mopey, and filler and "Brotox" can help polish the look. Since the appearance of sadness doesn't come from one area of your face, little adjustments can make a huge difference. Only filling the nasiolabial crease or fold is a technique that can lead to unnatural results if that is the only area of focus for fillers. It's important to find a plastic surgeon that has a natural eye for your overall appearance- even on the areas not included in your photo.  People often leave out correction of the cheeks which can make you look old and tired or sad. Hope this helps.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (Cheek Implants, Chin Implants), liposuction and or facelifts for over 30 years.  Following the beauty principles outlined in my book on face and body beauty, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  From the photos, your cheeks are flat anteriorly (in the front), there is excess fat below and in front of the cheeks with mandibular angles that are weak. These combine to create a wide, oval shaped face.  The following procedures would create an angular, more ruggedly handsome face.Cheek augmentation with cheek implants to add angularity to the cheeks and mid face.  This would be combined with liposuction to reduce the excess facial fat to further define the cheek shape.
Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line. Despite its recent popularity, fat transfer (fat injections) is far less reliable at providing a precise volume for facial shaping.  For that reason, I do not use fat to shape and contour the cheeks, chin or jaw line.

Hope this helps.

My face always looks sad. What can I do? (photos)

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