Which procedure would help correct fullness in the lower face? (photos)

Question

I’ve always had a strong jaw / chin, but I’ve seen my face start to droop a bit more as I’ve aged and as I’ve used masseter Botox more. Im particularly bothered by the squareness (mostly soft tissue, to the touch) and the mound under my lips. What can I do?

Lucian Ion, FRCS · Answer

Thank you for your question and for sharing your photographs. In general, masseter Botox relaxes the soft tissue along the jawline slightly, which may be part of what you are noticing. If you prefer the appearance of the jawline with reduced fullness of the masseter muscles, a small amount of skin tightening tends to be the solution.

For the contours below the lower lip muscles, injectable filler treatment or fat transfer are more frequently used solutions. I would suggest starting with injectable fillers, as they represent a reversible option. If you do not like the impact of the treatment, you can have them removed.

Gary M. Horndeski, MD · Answer

One thing to consider is a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This may change your circumoral appearance and improve it.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Nelson Lee Novick, MD · Answer

At least from the photos provided, there appears to some lack of chin projection in profile view and a somewhat pronounced mental crease (the horizontal depression between the upper chin and lower lip, which is contributing to the appearance of the perioral mounds. If this is indeed so, The a robust HA volumizing filler properly injected can augment the chin and enhance its projection (which, in turn will help to straighten and define the jawline in profile view). The mental crease, then can be elevated and smoothed more with a robust HA lifting filler. And, finally, the depressions to the sides of the mouth (that are contributing to the sides of the perioral mounds, can be smoothed with a low viscosity, Cohesive, malleable HA filler. All of the aforementioned treatments can be performed in one treatment session of about a half hour in experienced hands with immediate, on-the-spot results. You would be wise to make sure to consult a board certified cosmetic dermatologist filler expert. Best of luck.

Mats Hagstrom, MD (license on probation) · Answer

Having a large mandible serves most people well. Those who have small mandible are prone to having premature double chins, loss of jawline definition, premature jowls and other signs of premature aging. 
Peri-oral mounds are poorly understood and treatments are inherently limited. For this reason you may hear different explanations and different treatments options. 
I would insist on seeing before and after pics before signing up for surgery, 
While you seem to not like the large mandible it is serving you well in so many ways those with a small mandible desperately wish they had. Reducing the mandible does not seem reasonable and soft tissues are not the problem leaving you with few good and no great treatment options. 
For the above reasons my best recommendation is to not have intervention.
Different providers may differ for legitimate good reason. Avoid surgeons looking to try some new approach or “it should help” situations. 
Best,
Mats Hagstrom, MD

Which procedure would help correct fullness in the lower face? (photos)

Answers (4)

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