Unfortunately, not even the best of HD photos is a good subsitute for an in-person examination that allows for palpation and manipulation of the skin. In this instance, the inclusion of a frontal view would have been extremely helpful. However, from what I can see in this profile view, there may be some flattening (loss of volume) in the upper cheeks, general loss of definition along the jawline and posterior angle of the jaw, as well as early jowl formation along the jawline--all of which are likely contributing to the apparent loss of the sharper, more youthful cervico-mental (neck-chin) angle. If this is indeed so, then the use of a volumizing filler to restore a more youthful high-cheek bone look, as well as volumizing filler for redefining the posterior angle of the jawline and reducing the jowl formation would be in order. In my NY practice I would use Voluma XC for cheeks and Restylane Lyft for the jawline (In my Israel satellite facility, where a far greater number of regulatory agency approved volumizing fillers are available, I would opt for Stylage XXL for the cheeks and Restylane Volyme for the jawline. As a final tightening, Botox microdroplets may be used in the neck and along the jawline a particular injection pattern to achieve jawline tightening and neck tightening, known as the "Nefertiti Lift." In short, simple nonsurgical rejuvenation techniques, such as those described here are likely to yield very gratifying results without the need for expensive, aggressive surgery, liposuction with attendant downtime, or even Kybella, which requires several treatments and also gives rise to a bullfrog neck-like swelling that can persist for two weeks. Results of injectable volumizer treatments are typically immediate and engender a "Wow!" reaction, while Botox results generally take about a week or so to be realized. Make sure that you consult with a board certified aesthetic physician and insist upon seeing his/her personal before and after photos before agreeing to proceed. Best of luck.
