Solution for Marionette Lines, Drooping Cheeks and Jawline - Options?

Question

I'm in my mid-thirties and have concerns with my cheeks, jowl area, and under eye area. As a follow up to my original post, I'm attaching a photo, which shows the areas of concern I have for more specific input on the best approach/procedure. I am wondering if fillers would work or would some other approach be better? I believe that I have a familial type aging in those areas, as I've had cheek dents since I was a child, but all much less apparent when I smile vs. having a relaxed expression.

Behrooz Torkian, MD · Answer

Hi Noreaster!

	Based on your picture and your description, it seems like a good filler treatment can help you.  

	The fillers to which I am referring are non-standard placements of FDA approved products for volumization of the face.  I would begin with the nasolabial folds, the marrionette lines, and also into the pre-jowel sulcus.  The type of filler does not matter in these areas as much as the placement of the filler itself.  

	In the picture, it also appears that you may have a retrusive or small chin.  In many cases, a small chin may accentuate the appearance of the jowels and marionette area thus enhancing what may appear as early aging signs in the face.  An in-person evaulation or pictures from the side, and 3/4 views would help to determine this.  While a filler treatment in the chin area may help with this appearance, a chin implant may be a better way to get longer lasting cost-effective results.

	Good Luck

	Dr. Torkian - Lasky Clinic, Beverly Hills

Nima Shemirani, MD · Answer

Hi @noreaster. You would be a great candidate for hyaluronic acid dermal fillers and Morpheus 8.  Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin 
tightening and lifting. Best of luck, Dr. Nima!

Rupert Critchley, MD, MRCGP · Answer

Hi there! Thank you for the images. 
Personally, I would suggest some mid-face / lower face rejuvenation using hyaluronic acid based dermal filler in the midface to create lift and soften these lines. Dermal fillers can be used with great results to improve proportions / contours. Personally I would use Juvederm Voluma with microcannular to reduce risk of bruising too. 
Hope this helps and good luck,
Best wishes, 
Dr Rupert

Jed H. Horowitz, MD, FACS · Answer

A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift. During your #consultation,  your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect.If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

Jeff Angobaldo, MD · Answer

Thank you for submitting your question. Botox can help alleviate some of the dynamic lines in the lower lip, and chin. It will may also help lift the corner of the mouth. For facial volume, consider fat transfer and/or fillers.  Make an appointment with an expert injector to discuss the best treatment plan. Best Wishes

Jerome Edelstein, MD · Answer

Fillers are great for replacing volume lost from aging, which is what you have. You may want to consider Voluma, the latest from Juvederm.  Voluma has been specially formulated to restore facial volume lost over time and is the first of its kind.

Solution for Marionette Lines, Drooping Cheeks and Jawline - Options?

Answers (6)