Options to ease the appearance of loose pocket near laugh lines? (Photo)

Hello, I am a 40 yr old female with a loose pocket of skin near my laugh lines as well as some slight wrinkling in my lower face adjacent to this pocket. What are options available to me for fixing it? Can this be done via filler on either side of it? It's only on one side of my face and looking back thru photos it's been there since my early twenties but becoming more pronounced as I've gotten older.

Doctor Answers 3

Available options

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Thank you for your question. Juvederm Voluma along the cheek bone will give you a lift. Should this not be sufficient to get rid of the wrinkle, fillers may be used. 


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The pictures you have submitted represent the beginning of jowl formation. Our facial skin has an inner layer between it and the muscles of facial expression called the Superficial Muscular Aponeurotic System (SMAS). The SMAS becomes loose with time and because of the facial attachment to this layer, the skin is pulled down with "gravity" in a sliding fashion creating the marionette lines and the "pockets" you are describing. The gold standard for correcting the jowls is a minilift, a procedure that can be performed under local anesthesia to bring back the tissues to their original place. Fillers can be used to mask the effect for a little while but the most natural result would still be to correct the problem underneath the skin. The technique that I have developed utilizes seamless closure without stitches on the outside of the skin surface. Consult with a facial plastic surgeon in your area regarding conservative minilift techniques and fillers for the smile lines and the marionette lines to learn more.

Tal Dagan, MD, FACS
New York Physician

Facial asymmetry

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Filler is an excellent choice to help manage mild facial asymmetry.  Your face is quite slender, so any loss of volume in the facial fat pads makes a more pronounced change in your features.  Conservative placement of fillers along the cheekbone to give a slight lift to the mid face and more superficial placement of filler around the area of concern in the lower face should give you the look you're after.  Best of luck to you!

Suzan McGary, MD
Williamsport Thoracic Surgeon

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