Mini Facelift or Fillers for Chin and Jowl? (photo)

Since you have a nice neck and jawline, you can get lots of mileage from a "liquid facelift" using fillers like Restylane and Perlane to restore lost volume and give a very healthy refreshed look.

You are really the kind of person that these options were designed for.  You are a young lady with very early signs of facial aging affecting primarily her lower cheeks and jawline at the jowls.  A lot of the decision as to what to do rests with you.  While a mini-facelift is indicated and can certainly tighten up your jawline tissues, bear in mind that it is a surgical procedure with the risks and expense associated with that.  Those are lower than with full facelift to be sure, as you can usually do a mini facelift under local anesthesia if desired, and the extent of the procedure is not as great, but they are still very real.  The results will be good, but they will probably begin to reverse around 5 years later, and you may want more done.  Everyone has a certain number of lifting procedures "in her" before she starts to look distorted and "done."  Therefore, the earlier you start, the earlier you hit that threshold.  One of the long overlooked issues with facial aging has been volume loss, and not just looseness.  While facelifts address looseness, they do very little if anything to address volume loss.  For that you typically must add back volume strategically with either fillers or fat transfer.  Either would be appropriate for you.  I would encourage you to strongly consider a plan using Radiesse along your jaw line to address the lateral chin and perhaps create more chin projection if you wish, and Sculptra in the mid-cheek to add some volume there as well.  This will also create some lift on the jowl.  Lastly, consider some Radiesse in the upper cheek/malar region to create some lift of your cheekbones and youthful balance to your face.  Perhaps some Perlane in the tear troughs would complete the volume restoration around your orbit.  This plan will give you a very nice, natural improvement and save the surgery for a later time when the changes will be more significant and the results of the surgery more satisfying.  The good thing is that we have these options today whereas we didn't 10 years ago.

I think that you would really like the results from a mini-facelift.  It would give you back your more oval shaped face and get rid of your (although minimal) jowling.  I think your chin is fine, but if you want it to project a bit more, you could place a small implant at the time of your surgery without more recovery time.  Fillers are a great way to temporize an aging face, but correcting the problem with a lift is a better answer if you are willing to have surgery.  Good luck!  K. Roxanne Grawe, MD Columbus Plastic Surgeon

Thank you for your question.  My approach to early jowl formation is to do a mini facelift.

Dermal fillers can be injected into the area in front of the jowl and can improve it temporarily.  However dermal filler injection into the pre-jowl sulcus is prone to form lumps and almost always causes bruising because of the presence of the anterior facial artery and vein in this region. In addition the constant motion of the mouth and the muscles around the mouth can cause early dissolution of the filler and recurrence of the jowl.

 From the photos provided, the cheeks are a bit flat, there are jowls present, the chin is a bit weak and there is a small amount of excess skin under the neck.  A minimal incision Facelift, fillers to augment the cheeks (I prefer using Perlane), a chin augmentation with a chin implant combined with excision of the excess skin would make the face more feminine in appearance.  Fillers to the jowls will ad volume and soften the jowls but there won't be any removal of excess facial skin as can be achieved with the facelift.

It used to be that a facelift was the only option for the appearance of a jowl. But that's no longer the case. What I see in your photos is a face that is very long and very thin. At the age of 40 there is a loss of supportive soft tissue in the deeper areas of the face, and less robust and healthy collagen in the skin. This creates a depleted look, and skin that lacks sufficient tone. Returning volume and tone to the skin and underlying supportive soft tissue will create a softer and toned appearance and can actually create a lift of the jowl without surgery. Sculptra is the best way to nonsurgically create that youthful look. With surgery the jowl may be tightened, but the effect may not necessarily mimic a youthful appearance.

Your question is commonly asked in my practice. The surgical lift will give you a better long term result than fillers. The chin augmentation can be accomplished at the same time with an implant or a fat fill. Consult a board certified plastic surgeon in your area for a consult and exam. Dr Thomas Narsete Austin, Tx

You could choose either option, but I believe you would get superior results and a better overall aesthetic appearance if you chose the mini-lift. It is true that fillers are easier and quicker in many ways, but my concern is that you would have to use so many syringes to address your cheeks and jawline area that you may easily wind up spending almost as much money as you would for a surgery.  The mini-lift would help reposition your cheeks to a higher, natural position and would address the jowls that you mentioned. The overall effect would be a sharper more defined jawline and a more rounded youthful face. A small chin implant would enhance this procedure and give you more projection and balance in the chin area, but this is not an absolute necessity.  This is something best discussed with your surgeon in person.

Fillers would hide or disguise your jowls but would also add more weight or volume to the lower part of your face.  You could lift your cheek with more volume (fillers) but unless you use fat transfer or possibly Sculptra, you will be replacing these fillers again in 6-8 months.

Your question is very common. The first thing I like patients to realize is that very often these treatments are not mutually exclusive but complimentary . Having said that you don't appear to have a lot of excess laxity and you have a good jawline so I think you likely would have a great result with Sculptra and Restylane/Juvederm. This treatment would likely let you put off surgery for now.

  I agree that despite your providing adequate photographs, nothing takes the place of a face to face interview and examination.  Particularly, I would like to listen to your goals and your expectations for this treatment.  Either approach is fine, but I think you'd be happier with a mini facelift than with the fillers and "liquid facelift" that others have suggested.  Take a look at what wonderful results an S Lift can offer.  Good luck.