Why does my face look saggy under my eyes, around my nose and making my laugh lines more visible? I'm only 24 years old (photo)

Question

My face used to be rounder but then I got the botox in the masseter muscles so my face isn't so round which I'm happy with but around my nose and under my eyes my face seems to be sagging. I lost weight so I'm wondering if that's what caused it. It can't be the Botox right? Because that was back in Dec 2016. What would you recommend to fix the sagginess? It's making my laugh lines more visible as well. Especially my left side.

John Tang, MD · Answer

Thanks for your question.  The Botox placed in the massenter muscle is not the reason why the face appears "saggy."  The areas that you are concerned are caused by a loss of volume underneath the eye (tear troughs) and the laugh lines.  This is caused by the weight loss, sun exposure, genetics, and aging (even at 24!).  I would recommend that you consider a dermal filler to restore the volume loss.  I would start out with Restylane to fill the eyes and use the remainder for the rest of the area.  You will need 1-2 syringes.  Good luck!

Michael P. Morrissette, DDS, FACS · Answer

Thank you for your question and you have beautiful eyes. In some people, the area of the cheek below the eyes is flat due to genetics. Treatment options to lift the tissue include fillers which are temporary, or silicone cheek implants which are permanent. This is a very common area of complaint for many patients.

Harold J. Kaplan, MD · Answer

Hi Joanna.  You may have pointed out the main culprit when you mentioned the weight loss.  Losing weight very often causes the skin in the facial area to appear looser.  The upper area is pointing to something called the nasojugal groove and this can become more visible as we age.  A small amount of dermal fillers suchas Restylane, Lyft or Radiesse would really help you hide the concerns you are pointing out.  To see examples of before and after photos from our Orange County office, click on the link below.

Kenneth D. Steinsapir, MD · Answer

A small amount of Restylane would make a very nice difference here and last over a year.  You have profound upper eyelid ptosis and I think you would benefit from having this surgically addressed.

Jason Emer, MD · Answer

It is unlikely this is from your Botox treatment, but can be a result of the weight loss. Volume of the face can be improved with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Why does my face look saggy under my eyes, around my nose and making my laugh lines more visible? I'm only 24 years old (photo)

Answers (10)

Answer: Less is more.

Answer: Less is more.

Answer: Improving facial volume with Fillers (Radiesse, Voluma, Bellafill), Sculptra, implants, fat

Answer: Improving facial volume with Fillers (Radiesse, Voluma, Bellafill), Sculptra, implants, fat

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Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.

Why does my face look saggy under my eyes, around my nose and making my laugh lines more visible? I'm only 24 years old (photo)

Answers (10)

Answer: Less is more.

Answer: Less is more.

Answer: Improving facial volume with Fillers (Radiesse, Voluma, Bellafill), Sculptra, implants, fat

Answer: Improving facial volume with Fillers (Radiesse, Voluma, Bellafill), Sculptra, implants, fat

Browse related questions

Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.