What combination of filler/botox do I need to look less tired and achieve better facial symmetry? (Photo)

I am a 25yo F. 1) I always look tired because of my dark under-eye circles and 2) R side of my face is thinner than my left, esp in cheek and jowls. What combination of fillers/botox would you recommend and where so that I look less tired and achieve better facial symmetry? (I don't care whether we match L to R or R to L, whichever one achieves a more youthful/feminine facial contour, though I wish I had slightly less lower cheek fat on my L side.)

Doctor Answers 10

Combination filler and botox for facial symmetry

Botox can be used to smooth the forehead and provide a subtle brow lift. Restylane or Silk can be used to improve the dark circles under the eyes while Lyft can be used to elevate the cheeks. 

San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

Botox and Fillers in your 20's

I would recommend a combination of Botox in your upper face and Masseter muscle and Voluma to give you a little lift and beautiful results.  Please consult an expert.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Botox and Filler

Hello.  Thank you for your question.

These things are a bit tricky to explain across a computer screen.  Hopefully this will be helpful.  The general algorithm is that Botox is effective in the “upper ⅓” of the face: forehead lines, crow’s feet, and lines between the eyebrows. These lines are “dynamic” lines, caused by underlying muscle contractions. By relaxing the associated muscles, Botox smoothens the upper ⅓ of the face.

“Static” lines in the lower face, such as the nasolabial folds, are amenable to facial filler.  Per your concerns, filler may also be used to enhance the malar (cheek) area.

Hope this is helpful. Best wishes. Dr. Shah

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Options for facial symmetry and contouring

Thank you for your question. For dark circles under the eyes, a filler such a Belotero may be a great option for you. Definitely consult with a Plastic Surgeon in your area to determine which filler is best for you. In terms of jowl asymmetry, ThermiTight may be a great option for you. This is a micro-invasive procedure that uses controlled radiofrequency heat to melt fat and tighten/lift the skin simultaneously. There is absolutely no downtime and this procedure it's usually done under local anesthesia. The temperatures used to target tightening/lifting and fat/fullness differ. Heat would be applied to both sides of your face to promote the tightening/lifting effect and temperature would be adjusted to target the fat/fullness on the left side of your face. Please consult with a Thermi expert in your area to see if you're a good candidate for ThermiTight. Good luck!

Brian M. Kinney, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 13 reviews

Botox and fillers for a youthful facial contour

A cosmetic dermatologist or plastic surgeon will be able to assess your face and determine how the use of Botox and fillers can give you a younger, more pleasing appearance.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Facial Sculpting Using Fillers Like Voluma, Radiesse, Lyft, Juvederm and Sculptra and Fat

I suggest seeing a cosmetic dermatologist or plastic surgeon who is an expert in facial sculpting and combination treatments.  Using fillers, skin care, botox, lasers and microfocused ultrasound or RF you could get a very great improvement with little downtime.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews



Thank you for your question.

It is very common to have facial asymmetry and a difference in muscle movement on each side of the face. It is difficult to provide a treatment plan without a full assessment. If this is something that bothers you, it may be helpful to discuss subtle options for injectable treatment, (both Filler and Botox or Dysport for example.) with a skilled injector, and then decide if that's the right option for you.

All the best.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

What combination of filler/botox do I need to look less tired and achieve better facial symmetry?

Hello Missmoss1213

WHen it comes to facial symmetry, no one really has it.  One side is usually larger than the other.  A brow might be higher on one side.  The corner of the mouth may be higher.  A cheek bone may be larger.  It is important to realize that a goal of perfect symmetry is nearly unattainable and it has to do with embryology.  So if your goal is to be perfectly symmetric, there really isn't any treatment that will do that for you.  

As far as what an be done, for the under eye area you can try to conceal the circles with make up, fill the area with the shadow with fillers to make the shadow less noticeable, or undergo a surgery to get rid of the root cause of the eye bags which is casting the shadow.  To verify you have a bag there casting the shadow, an in person evaluation would be needed.  It is also possible to simply have a bluish color under the eye from blood vessels getting blocked up.  In this case the use of topical products that cause blood vessels to shrink, allergy medicine, and make up may be the better option.  

If you are considering Botox, it is designed to minimize muscle activity and the wrinkles that develop with activity.  

What I'd recommend is you consult with a facial plastic surgeon or plastic surgeon to learn about the non surgical options as well as the surgical options so you can make an informed decision on what you'd like to do.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews


Thank you for your question in regards to Botox.
Botox is used to soften the appearance of fine lines and wrinkles, where as fillers are used to add volume. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews


Thanks for your question.  Botox is a temporary neuroparalytic that is used to eliminate wrinkles in the periorbital and forehead area.  Its also works well for softening the 11s (corrugated muscle).  Fillers are used to add volume to the face and also deal with dipper folds and lines such as the smile lines and marionette lines.  In addition filler can be used for filling the tear trough deformity and adding volume to the cheeks and lips.  Please consult with your plastic surgeon to review the best options available for you.
Good Luck.

Ali Sadeghi, MD, FACS
New Orleans Plastic Surgeon
4.8 out of 5 stars 25 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.