Do I have saggy jowls or is it fat & what's the treatment? (photos)

Hi @sabrinasabb! I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

Hi, there! It is perfectly natural for a person's face to get wider when they smile. Judging from your photos, you don't really have a lot of buccal fat so a buccal fat excision might not give you the results you want. That being said, as we age, the skin will sag creating an illusion that we have a wider lower face. It is something we can reverse by threading or a microlift, which I recommend for longer-lasting results. If you are interested in microlift, you can learn more about the procedure online.

Sincerely,
Philip J. Miller, MD, FACS Double Board-Certified Facial Plastic Surgeon