43 - Why has my face changed so much in 5 years and what can I do to reverse this? (Photos)

Question

These pictures are ~5 years apart. I am trying to figure out if the changes in my face are natural aging, one round of cheek fillers that possibly migrated (I don't know this for a fact but speculating), weight gain, TMJ related (I have arthritis in my jaw, grind my teeth, and wear a mouth guard at night) or something else. What would help? Jaw surgery? A facelift? I'm 43.

Anna Chacon, MD, FAAD · Answer

At age 43, it’s completely normal to start noticing more significant changes in your face compared to your late 30s. These changes are often multifactorial and can be influenced by a combination of natural aging, volume shifts, lifestyle factors, and even underlying medical conditions such as TMJ.

Here are several key contributors that may explain what you're observing:

Natural Aging: Around the early 40s, we begin to experience midface volume loss, skin laxity, deepening of nasolabial folds, and some degree of bone resorption, especially around the jawline and cheeks. Collagen and elastin decline also play a role in skin firmness and facial support.

Previous Fillers: If you had cheek fillers in the past, product migration or poor integration could alter facial contours subtly over time. This could lead to puffiness, imbalance, or even an unnatural fullness in unintended areas.

Weight Fluctuations: Gaining weight can increase facial volume but in a way that may look heavier or less contoured, especially if it is not balanced with structural support in the midface or jawline.

TMJ and Jaw Tension: Chronic clenching or grinding can change the shape of the lower face over time, potentially enlarging the masseter muscles or altering jaw angles. Arthritis in the jaw joint may also impact symmetry or contribute to discomfort and facial imbalance.

As for solutions, it depends on your specific concerns and goals:

Non-surgical treatments like strategic use of fillers (e.g., restoring midface or jawline definition), neuromodulators to relax the masseters, or skin tightening modalities (radiofrequency, ultrasound, or lasers) can offer natural rejuvenation with little downtime.

Renuva or biostimulators can also be explored to replace lost fat if volume loss is the main issue.

Jaw surgery or a lower facelift may be worth considering in cases where structural changes or more advanced skin laxity are present, especially if non-invasive options fall short.

A personalized facial assessment is key to understanding which combination of factors is at play and what approach will help you look and feel more refreshed—while still looking like yourself.

43 - Why has my face changed so much in 5 years and what can I do to reverse this? (Photos)

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Everything you need to know about Cheek Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.

43 - Why has my face changed so much in 5 years and what can I do to reverse this? (Photos)

Answers (1)

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Recommended reading

Everything you need to know about Cheek Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.