Hi, from the attached photos the most accurate seems to be the far left non smiling "after" photo. The "before" photo seems much earlier, younger with fuller cheeks as you smile. From these photos your cheeks are very flat anteriorly (in the front) and there is evidence of jowls that are absent form the "before" picture. Voluma to the outer portion of the cheeks, IMHO, broadens and masculinizes a womans face. I prefer shaping the cheek by placing the dermal filler in the "apple" (front portion) of the cheeks which feminizes the face. Having said that the dermal filler or Botox should not have caused such a sudden aged appearance to the face. You can go back and have the Voluma dissolved with hyaluronidase by the MD that peformed the dermal filler injection if you are unhappy with the results. Following the beauty principles outlined in my book on face and body beauty, 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 using a dermal filler (I prefer Restylane Lyft) or with cheek implants for a permanent enhancement will create full, round cheeks anteriorly that will feminize the entire face. Jowls are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured. 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 and subperiosteal facelifts) but with these added benefits: •very small incisions •minimal tissue dissection = less bruising and swelling = rapid recovery •can be performed in 90 minutes or less, with or without anesthesia •no incisions within the hair = no hair loss •excess fat can be removed •excess skin removed •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 Hope this helps.