How to slim bottom face ( Botox, buccal fat, lower facelift)? (Photos)

Question

Hello, I’m 22 and I am Korean. my bottom face is bulky asymmetrical. Ultherapy had not effect sadly on me. I wonder what procedure I should get done to get a Vline face as I don’t want to go under the knife for bone cutting surgery in Korea. Jaw botox did help a little bit, but it almost look like I have sagging skin and/or jowl at 22. Should I get buccal fat removal? Lower face lift?

Carl Truesdale, MD · Answer

The right approach depends on what specifically is creating the lower-face fullness.
Masseter muscle hypertrophy:The masseter at the back of the jaw can be enlarged from teeth grinding, chewing tough food, or genetics. Treatment: masseter Botox. Shrinks the muscle bulk over 4 to 8 weeks. Lasts 4 to 6 months per treatment. Best for patients with a square jaw look driven by muscle, not fat.
Buccal fat (cheek hollow fat):The buccal fat pad sits in the lower cheek hollow. Removing it creates a more sculpted lower face. Permanent. Reserved for patients with significant buccal fullness &mdash; NOT a routine slimming tool.
Important caveat: removing buccal fat in your 20s or 30s often creates a gaunt, hollow appearance in your 40s and 50s as the face naturally thins. The 'regret rate' on buccal fat removal in young patients is high. Only do this if you have clear, persistent buccal fullness AND realistic understanding of how your face will age.
Lower facelift:For patients with skin laxity, jowls, or platysmal banding (usually 40+), a lower facelift repositions the SMAS and removes excess skin envelope. Sharpens the jawline. This is the right tool for aging-related lower face fullness, not for naturally round-faced patients in their 20s to 30s.
Decision framework:
Under 30 with round face: masseter Botox first. See result over 3 to 6 months. Conservative buccal fat reduction ONLY if you can pinch obvious buccal fullness AND have a thinner face genetically.
30 to 40 with early jowling or fat: combination of masseter Botox + careful submental liposuction. Hold off on buccal fat removal.
40+ with jowls and skin laxity: lower facelift, possibly with masseter Botox addition.
What to avoid at any age: aggressive buccal fat removal hoping for a 'snatched' look (often regret-inducing), lower facelift in someone whose anatomy is muscle/fat-driven rather than laxity-driven, trying all three simultaneously without staged assessment.
Best move: in-person consult with a surgeon who does all three. Ask them to evaluate masseter bulk by palpation when you bite down, buccal fat by pinching the cheek hollow, and skin laxity by the pinch test. The right answer becomes obvious with the exam.

How to slim bottom face ( Botox, buccal fat, lower facelift)? (Photos)

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