40 - looking for a frozen, plump face. Facelift or botox and filler? (Photos)

I have been injecting Botox for cosmetic reasons since 1991. In the early days, we thought that "freezing" the muscles of facial expression was the way to go. Later we learned, that a frozen, "Kabuki dancer"-like face that was unable to move was way too artificial looking. And, so we changed to injecting Botox to calm down the dynamic muscles of facial expression so that a person could still smile, raise eyebrows, etc. when they wanted to, but looked much smoother at rest. However, if someone really wanted to look "frozen," we can merely increase the concentration and amount of Botox to achieve this.
From the photos provided, there appears to be a considerable amount of volume deficit n the cheeks. Since mid-cheek volume provides the major support for the under-eyes and is also responsible for lift from the cheeks (without which smile lines deepen), replenishing this volume with the use of an appropriately robust HA lifting filler can in one fell swoop recontour a more feminine Ogee Curve, diminish tear trough formation under the eyes, and soften the smile lines to the sides of the nose.
In experienced hands, all of the above can be performed in one treatment sessions of about 30 minutes and typically engenders little to no significant post-treatment downtime.
You would be wise to make sure to consult an experienced, board certified cosmetic dermatologist injector expert. Best of luck.

If you've been doing little procedures to keep yourself rejuvenated and still feel dissatisfied, consider fillers to the temples and NOT the cheeks. The lateral will only make you look deflated and sunken in your temples and appear older. Also, consider tightening the skin with Morpheus and or IPL.

At age 40, it’s common to notice changes in facial volume, skin elasticity, and contour. Many people in your age group are excellent candidates for non-surgical treatments, but the best approach depends on your goals and anatomy.

1. “Frozen” Look:
If you want minimal facial movement (the “frozen” look), onabotulinumtoxinA (Botox) is the mainstay. Botox works by relaxing the muscles that cause dynamic wrinkles, especially in the forehead, glabella (between the brows), and crow’s feet. For a more “frozen” effect, your injector can use higher doses or treat more areas, but it’s important to balance this with a natural appearance and avoid heaviness or drooping.

2. Plumpness:
Loss of facial volume is a hallmark of aging. Hyaluronic acid fillers (like Juvederm, Restylane, or similar) can restore plumpness to the cheeks, lips, nasolabial folds, and under-eye area. For a more sculpted jawline, fillers can also be used to contour and soften a square appearance.

3. Jawline Concerns:
A squarer jawline can result from volume loss in the midface, increased masseter muscle activity, or changes in skin laxity.

Fillers can help restore midface volume and soften the jawline.
Botox can be injected into the masseter muscles to slim the lower face if muscle hypertrophy is contributing.
Skin tightening treatments (like radiofrequency or ultrasound-based devices) can also help with mild laxity.
4. Facelift:
At 40, most patients do not require a surgical facelift unless there is significant skin laxity or sagging that cannot be addressed with non-surgical options. Facelifts are more invasive, require downtime, and are typically reserved for more advanced aging changes.

What to Ask For at Your Next Appointment:

Express your desire for a “frozen” look with Botox, but discuss the risks of over-treatment (such as heaviness or unnatural appearance).
Ask about filler options for restoring volume in the cheeks, lips, and jawline.
Inquire about masseter Botox if you want a slimmer jawline.
Discuss non-surgical skin tightening options if you have mild sagging.
Bring photos of your younger self or examples of your aesthetic goals to help guide your provider.
Summary:
For most 40-year-olds, a combination of Botox and fillers can achieve a refreshed, plumper, and even “frozen” look without surgery. A facelift is rarely needed at this stage unless there is significant sagging. The best results come from a personalized plan created with an experienced injector who understands your goals.

If you’re interested in long-term strategies, consider asking about preventative treatments and lifestyle modifications that can help maintain your results and slow further aging, such as medical-grade skincare, sun protection, and collagen-stimulating procedures.

Based on the three post photos, I recommend a combination of mini face neck lift with muscle tightening with fat grafting to areas of the face. Fee $12,000-$18,000. Best of virtual consultant with.