How can I add volume to the following areas?

Hi, filling the cheeks and chin is pretty standard, but for my own aesthetic, I use my patient's younger photos to make sure I am not turning them into a caricature of themselves, but instead honor their younger selves and make sure I am helping them to look like themselves and not a different person. Of course, it the person wants to look like a different person, that can be done, too, but I prefer to help my patients who have a good self image to maintain that "look" over the decades and not make decisions they will regret in only a few years. The forehead is an area which can be filled, but needs to be done with great caution. There is a procedure that we do in facial plastic surgery to reconstruct a person's nose after cancer surgery. This is called a paramedian forehead flap. The blood vessels which supply this flap runs along the medial part of the eyebrow running vertically upwards. I have recently witnessed injectors on Instagram injecting with a needle right along this area, and the only caveat is to "draw back" on the syringe prior to injecting. The problem with this technique is that the filler is very thick, and drawing back on fillers is different than drawing back with a saline solution like IV fluid, which nurses often do when placing an IV or drawing blood through an IV. I have a patient who visits me for nearly a decade from the New England area. I saw her recently and she had a scar on her forehead which she did not have from before. During the pandemic, she had her forehead indention injected by a facial plastic surgeon who specializes in Facial Feminization in her area and injected into the blood vessel. A vertical patch of skin lost its blood supply and scabbed up due to the loss of oxygen. This left her with a scar and the same pre-existing forehead indentation. The surgeon did not immediately inject hyaluronidase when this happened and gave her nitroglycerin paste to apply on the dying skin. Also told her to go get hyperbaric oxygen, but with no referral. When I see certain injections being shown on Instagram, it makes me very nervous, since many of the injectors are learning from each other on IG. It's like showing kids an stuntman performing a stunt on TV and you worry that children will try to copy them and end up hurting themselves or other people. Anyway, I hope this reply provided some value. Good luck. Best, Dr. Yang

Hello, and thank you for your question. Dermal fillers can help restore lost volume in your face. When injected into specific target areas, these gel-like substances provide moisture and volume for immediate smoothing and lifting, as well as enhancing facial contours. Fillers would be very effective in addressing your dimples and dents in the cheeks, as well as your weak chin. And there are other treatments you can explore, particularly those that stimulate collagen production. Laser and energy devices, Profound RF (RF microneedling), chemical peels, fat transfer, and PDO thread lifts can help tighten, firm, and lift the skin. To learn more about your options, it is best to schedule an in-person consultation with a reputable board-certified facial plastic surgeon who can assess your skin quality and facial profile, customize the best treatment plan for you, and ensure the best possible outcome.

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.