Which dermal fillers would I benefit from as my face looks very flat?

Question

I'm 25 F and want to feminize my face. Will dermal fillers make a significant difference in my cheeks and if I get a cheek filler then would it still be necessary for me to get a tear trough filler for sunken eyes. I wanted to slim my jaw with Botox and was curious how many units I'd need & my lips are never smooth, are they dry or loss of volume? Do I need filler or lip blushing? If you could tell me the costs at your office for treatment

Jason Emer, MD · Answer

fillers to contour and sculptra for lifting and sculpting long term would do great for you.

most of my younger patients do buccal fat pad reduction, facetite/liposuction of the neck, and fillers to chin/cheeks/jawline/temples,  to give them a more chiseled face.  see my IG and links. at home derma-rolling should be started to Improve texture and tone and tightening along jawline (see link where we have a recommended daily skincare and weekly MTS + anteageMD derma-rolling protocol).

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

most of my younger patients consider...
5. deep microneelding RF like morpheus every 2-3 months forever to further improvement tightening
6. early face/neck lift if you want a really tight contour and the most extreme improvement in jawline and neck shaping
7. threads, PDO or Instalift, after neck surgery/facetite to further improve the outcomes and give them long term collagen production and shaping
8. Thermage (radio frequency heating) and Ultherapy (ultrasound muscle tightening) yearly to prevent sagging in the future

See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option.  Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

Photos are no substitute for an in-person examination that allows for palpation and manipulation of the skin. From the photos at least, it does appear that the addition of a volumizing filler to the midface region would create a more ideal, feminine heart-shaped face. Fees vary with the precise injectable chosen and the amount needed to get the job done. You should figure for Manhattan in the range of 775-975 for the treatment. From what can be extrapolated from the photos, simply revolumizing the midface should secondarily improve the under eye region without the need for direct treatment of the tear trough region.  Hope this helps. Best of luck.

Michele S. Green, MD · Answer

The main issue here seems to be volume loss and I would want to restore this lost volume. Two syringes of Voluma (one in each cheek) would add some beautiful structure and replace lost collagen. I would add a small amount of Botox in the glabella and Botox the masseter area to give you a less square jaw. Finally, some subtle lip augmentation with Restylane Kysse would be best for you. Please consult an expert in facial rejuvenation for the best cosmetic results. Best, Dr. Green in NYC

Matt Tahsini, MD · Answer

Hello and thank you for your question. It looks like you could use some filler which would help add some shape to your face. Find a very experienced person to do the injections as this could make or break your results. Best wishes.
Dr. T

Solomon Facial Plastic - Thornhill · Answer

Hi there, I agree that you could benefit from cheek volumization. I would start with a minimum of 2 syringes to make a difference, 1 per cheek. I would start with your lateral cheeks (cheek bone) and you medial cheek (apple of the cheek). I would start there, cause there can often be some correction to the under eye area when the cheek volume is corrected. For the lips I would use a soft product that has lots of tissue integration to improve hydration and creepiness' of the lips. In terms of botox for facial slimming, each masseter requires 30-40 units/per side and 3-4 treatment sessions are required to achieve facial slimming.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question. Plumping the mid face is in my opinion the best use of Dermal fillers and creates the best cosmetic result.
You need a cross linked filler to last and hold the correction.
The best in my opinion are Restylane Lyft and Vobella.
Find an experienced board certified plastic surgeon who does a lot of filler injections. It is important to place the product carefully and avoid injection into a blood vessel

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