What treatment would be best to fix sagging cheek, nose to chin line and slight jowl? Also the indentation in my chin. (Photo)

Question

I’m 39 and was thinking about thread lift or would fillers be better? Also could I fix this strange indention I get on my chin sometimes? I’m aware it’s a muscle I’m tensing but not sure which one or why I do it? could Botox fix this? Thanks so much for any advice

Israr Wong, MBBS · Answer

Hi Summer78,
It looks like your exhibiting the typical signs of aging like nasolabial folds, jowls formation, strong mentalis muscle, cheek fat descent. 
You will need a combination therapy of lifting fillers at the cheeks , zygoma, nasolabial folds, and a lifting procedure like threadlift to lift the jowls and cheeks. 
Botulinium Toxin can be added to the mentalis muscle which causes the chin to be "scrunged up".

Victoria Manning, MD · Answer

Looking at your photos you do look like you would be
suitable for Silhouette Soft thread lift treatment, which can treat your
sagging mid face area and jowling. Silhouette Soft is
a skin lifting treatment which provides an immediate mechanical lifting effect
as well as a biological lift by stimulating the natural production of collagen
in the months that follow treatment. The results are immediate, but what’s even
better is that after three months, the Silhouette Soft induces
‘neo-collagenasis’ – a process by which the body produces its own collagen to
replace what age is diminishing, so you would get a really natural looking
result.   
 
A chin indentation is best treated with a
combination of Botulinum Toxin and dermal filler.  I would recommend Ellanse, a collagen
stimulating dermal filler which will naturally smooth out the indentation for
up to four years.  Our most frequently
performed treatment in our clinics is a combination of Silhouette Soft and
Ellanse.

Bruce E. Katz, MD · Answer

Thank you for your photo. I would definitely recommend a thread lift using Nova Threads. Nova Threads are dissolvable polydioxanone (PDO) threads made from the same dissolving material as surgical sutures. Nova Threads are placed beneath the skin to provide a support structure for new collagen growth while reducing the appearance of lines and wrinkles. We use Nova Threads to treat lower face skin laxity and facial wrinkles such as marionette lines, nasolabial folds and laugh lines. For more information please make sure you a get a in person consultation from a board-certified dermatologist.

Ian Hallam, MBE, BDS · Answer

Hi - thanks for your enquiry. The symptoms of sagging cheeks and an increase in naso-labial folds and marionette lines, as well as the signs of jowls and a natural part of the ageing process. In your case they are not excessive but can be corrected with a subtle combination of treatments.
The symptoms are a result of deflation of the natural fat compartments in the mid-face, particularly the anterior cheeks, which results in soft tissue decent causing an increase in the nsao-labial folds and the folds below the corner of the mouth (marionette lines) and also laxity along the jawline or jowls.
The first priority would be to restore the loss of volume in the cheeks using a filler and some fillers in the nose to chin lines. This would restore a more youthful appearance to the mid and lower face.
It would be ideal then to also consider a thread lift such as Silhouette Soft to lift the skin, tighten the jawline and support the cheeks. The collagen stimulation would help to maintain the lifting effect and reduce the tendency of further laxity.
The dimpling effect on your chin is a result of overactivity of the mentalis muscle. This sometimes occurs with a Class II jaw relationship which results in an increased overjet, when the lower teeth are positioned well behind the uppers when in occlusion. The dimpled effect can be reduced by a simple botulinum toxin injection to the mentalis muscle.
Interestingly a Class II jaw relationship also often results in marionette lines appearing at an earlier age because of a reduction in chin support. This can also be addressed by using a filler to increase chin projection and an improved facial profile.
I hope this is helpful
Best wishes
Dr Ian Hallam MBE

Liliana Manrique, MD · Answer

Thank you for the photo. The best assessment for a threadlift is done with a face in motion to plan on vectors. It looks from the photo that a reposition of tissues around the smile and marionette lines will address your concern. I will not advise fillers for you. Dr. LM.

What treatment would be best to fix sagging cheek, nose to chin line and slight jowl? Also the indentation in my chin. (Photo)

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Answers (5)

More Thread Lift Questions

I had dissolvable threads put in 3 wks ago to reduce sagging and lift jaws back to how they were. Now have indentations? (photo)

How long should I wait before resuming exercise after a PDO threadlift?

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