Radiesse or Lipo for Lifting Jowls and Marionette Lines?

Question

45 yrs old.  Within a year period I have had Radiesse, Restalyne, and Juvaderm Ultra-Plus for my marionette lines.  Minimal results that lasted apprx two months.  Now my doctor is recommending Radiesse in my upper cheeks to lift jaw line and marionette lines.  I can't afford a mini face lift.  Maybe lipo around jowl area would work?    Thanks

Ron Shelton, MD · Answer

For those patients who are dead set against having surgery, and don't mind repeated visits, even more than once per year, volumization may help them significantly obtain improvement in their appearance. Botox on the neck underneath the jowl can be done as an off-label use with some benefit to lift the cheek, liposuction can be done on the jowl (but this is surgery and there are risks) and tightening devices might improve the appearance, but all these treatements will not give you the same good result as a facelift it appears. It might be more cost effective for you to have the lift, although, you should realize that some patients still benefit from some filler for smile folds after a lift.

Ercan Karacaoglu, MD, FEBOPRAS · Answer

If the extent of face skin sagging is not considerable and the patient with marionette lines is not willing to have   surgery, then the use of dermal filler injections may be a great option. Dermal fillers are a class of cosmetic injections that are designed to add volume to the patient's face. By filling the lines, sagging can be reduced, and patient will get much younger look. For light form of M lines these fillers and injections could be a good relief but for deeper forms surely it can comparable to the surgical option's result, I mean face lift surgery.When marionette or nasolabial lines appear as a result of serious drooping and sagging of the skin in the lower part of the face, a lower facelift can be helpful. The lower facelift involves incisions made around the lower portion of the ear, allowing surgeons to tighten the facial skin and improve overall appearance in the process.

Farbod Esmailian, MD · Answer

I dont know what you have spent this year on all that filler, but I would recommend waiting, save your money and then get a facelift, which is what I really think you need and would benefit most from.
Good luck.

Michael A. Persky, MD · Answer

Hi New,
Sculptra done properly will restore volume to your face, at an approximate cost of 4 to 5 thousand dollars for complete correction.  Your alternative is to save for surgical correction.
Good luck and be well.
Dr. P

Otto Joseph Placik, MD · Answer

I am not a proponent of injecting fillers in the mid face to "lift" the lower face. This would take alot of filler and likely look strange. You already have prominent cheeks and I do not see any advantage to additional fillers for you . Personally, my advice would be to save your money for a face lift

Behrooz Torkian, MD · Answer

Hi, 
From looking at your picture I can tell that injectable treatments would only provide minimal improvement at best. The marionnette area is very difficult to fill enough to completely flatten once it has reached a certain point.  Cheek filler procedures using Radiesse can have very nice results with a wonderful impact on the face overall, however the lifting effect is minimal and not likely to give you what you are looking for in the lower face.  
A minilift would certainly help with this area. My recommendation would be to discuss financing options with your surgeon. With all that you have spent on injectsbles in the past year, a significant portion could have been paid off.  I hope this helps.

Grant Stevens, MD · Answer

Injections are not the gold standard but certainly can provide some improvement.   Neurotoxins have been used in the corner of the mouth  with good success.  This can turn the corner of your mouth upwards and together with fillers  should  improve the areas that bother you.  The proposed cheek injections will not change  the look of the corner of your mouth.

	I suggest that you save your money for a facelift.  

	Dr Grant Stevens

Pamela Carr, MD · Answer

The correct answer is always more likely to follow if the question is heard correctly. The youthful face is an inverted triangle.  As we age, with the descent of the cheek fat, the face becomes more rectangular.  By revolumizing the central third of the face with Radiesse or Sculptra a more triangular shape, a more youthful shape can be achieved.
Using tumescent liposuction to shave down the jowl pockets and revealing a more crisp jawline may also be beneficial.  However, I believe the best correction for your face to be a rhytidectomy (facelift).  I suspect any lessor procedure will not be the right answer to the question you are asking and you will be dissatisfied.

Darryl J. Blinski, MD · Answer

Better to have a jowl lift or mini facelift. The options you wish will not address the issues. Radiesse or any filler will only improve slightly the lines or folds. Lipo is not a choice I would ever consider. Regards.

Kamran Khoobehi, MD · Answer

You already have spend a lot of money and you could had the surgery. Filler are great option in right patients. If you will be happy with minimal result, then it is reasonable to try fillers,but do not expect much check lift.

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