Hi, I have performed many facial shaping procedure for over 30 years using dermal fillers, silastic facial implants (cheek implants, chin implants, lip implants), SMAS and many minimally invasive SMAS facelifts. From the photos your cheeks are a bit flat in the front (left more flat than right), there is significant excess fat in the mid and lower face (this accelerates the pull of gravity and creates sagging tissues of the face and neck), jowls are present, the chin is weak, the back portions of the jaw line are wean and there is excess fat and skin in the neck. These factors combine to create an elongated, rectangular shaped face. Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. Liposuction would be combined to reduce the excess fat to further shape the cheeks, neck and face. In contrast, buccal lipectomy (or removal of the buccal fat) is an old, outdated procedure that removes a teaspoon size portion of fat from below the cheek bone. As such, this technique can not change the "actual" shape of the cheek bone but can create hollowing in the face below the cheeks. This technique would not reduce the excess subcutaneous fat that exists in your mid face, lower face (jowl area) and neck. When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective. "Jowls” are sagging facial tissues and the main indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits: very small incisions and no incisions extend or are placed within the hair. minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned) can be performed in 90 minutes or less, with or without general anesthesia no incisions within the hair = no hair loss excess fat can be removed from the face and neck excess skin removed from the face and neck cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants most patients fly back home to parts all over the world in as little as 3 days post-op The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Hope this helps.