What cosmetic face procedure would I need to achieve this appearance? Age 20, jaw has a jowly appearance. (photo)

I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer.

Hi there,
Thank you for your question.
You sent us two photos. In the first photo, you appear to have small jowls along the jawline. This makes your face appear more square. In the second photo, your face appears more oval-looking. I can also see that you are of Asian origin.
To improve your jowls, you had masseter Botox. Masseter Botox is not a good option to treat jowls. Let me explain to you why.
Two main reasons can make the jaw look more square.
1. A masseter muscle that is too big.
Masseter Botox can improve a square face shape. This is because the masseter muscle is on both sides of the jaw. Sometimes, when this muscle is too big, it can make the jaw look square. Botox can slim this muscle, and as a result, the face looks more oval again.
2. Facial Sagging
As we age, the small fat pads in our faces start sagging downwards. These fat pads pile up on top of the jaw. As a result, the jawline can look square, and you can get jowls. Masseter Botox will not help in this case as it does not treat the fat pads but only the muscle. It can even make a square jawline worse. This is because the masseter muscle helps lift the fat pads in the lower face.
If you have a square jawline due to facial sagging, you must lift the fat pads in your face. This can be done with a non-surgical facelift. Options for a non-surgical facelift are dermal fillers and PDO-threads.
Sometimes, skin-tightening treatments, such as Microneedling with Radiofrequency or HiFU, can also improve facial sagging.

I would first make sure that the correct dose was given for masseter Botox because based on your photos it appears you are a good candidate. Other options would be surgical in nature including fat removal. See a board certified plastic surgeon near you for an evaluation.