What is the most effective, Non-invasive treatment for sagging jowl & cheeks (around the mouth)? (photos)

Question

I'm 29/F/5'1/110lbs. People always said I had 'chipmunk cheeks'. I had buccal fat removal 4 yrs ago. My lower cheeks (especially the area around my mouth), are saggy and I always look like I'm frowning. I'm not sure if it is r/t to the loss in volume of my cheek fat, but I'm looking for a non-invasive solution. The sagging is mostly noticeable from the side. Would I be a good candidate for Radiesse? Would a Chin/Cheek Augumentation decrease the sagging and give me a more proportional face?

Richard Balikian, MD · Answer

No non-invasive treatment it going to totally fix what is bothering you, but given your age, non-invasive treatments are still the best option for you to look your best. I believe 2-3 syringes of a cheek filler (my preference is Voluma) will be a good start to reset the harmony and balance of your face to be more lifted. Again, this will not make the sag you see go away, but it may improve it. Other non-invasive skin tightening procedures can than be added for a bit more tightening (RF treatment in my practice).

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.  Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Rupert Critchley, MD, MRCGP · Answer

Hi there! Thank you for the question and pictures
I think you would be a great candidate for hyaluronic acid based dermal filler as a non-surgical solution. 
Re-volumisation using dermal fillers are great when addressing facial contours, volume loss and aesthetic proportions, carefully placed product in cheek, jawline and chin would be an option looking at the pictures. 
Make sure you consult an expert aesthetic practitioner for face to face consultation. 
I hope this helps and good luck!

George Bitar, MD · Answer

At your age non surgical treatments such as fillers and non surgical skin tightening such as ultherapy would be helpful.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question.The most common treatments for your age group are usually a combination of ultrasonic or radiofrequency tightening along with strategic placement of fillers.

To be sure, see two or more experienced, licensed
and certified providers for a complete evaluation to make sure you are a good
candidate and that it is safe for you to have the procedure.

I hope this helps.

Jed H. Horowitz, MD, FACS · Answer

Improving jowels without surgeryThere are many energy sources that can tighten tissue and improve collagenWe use the Sciton Skin Tite.    this along with Voluma or other filler in the upper face can give some improvement

Camille Cash, MD · Answer

You will likely have the best outcome from a combination of treatments.  Botox or other neuromodulators can be used to slim the appearance of the jawline.  Fillers can be used to add structure and contour facial features.  Morpheus8 is a great treatment to improve overall skin tone and texture.  I've included a video that I hope you find helpful.

Sunanda Chugh, MD · Answer

I would recommend Ultherapy and/or PDO thread lift to help tighten and lift the lower face, and in essence reduce the jowling.  I would also consider placing a dermal filler on the chin to augment this area slightly and in doing so, give you a more defined profile.
Hope this helps!
Dr. Sunanda Chugh, MD

Daniel Chang, MSc, MBBS, MRCS · Answer

Dear Ngur0032,
Thank you for your question. You have a volume deficit that is quite common in Asian faces, flattened midface, small chin and square jawline. 
Here is what I suggest.
Microbotox + FillersLifting with ThreadliftMaintainence with energy based devices – RF, HIFU (Optional)
Micro-toxin would help shrink your jaw muscles.
Fillers help to revolumise, and I would focus on your midcheeks and chin to give you a more balanced, well proportioned, heart shaped face.
Threadlifts serve to lift, reposition and anchor your jowls.
HIFU and RF stimulate fibroblasts to induce neo-collagenesis.
All the above treatments promote collagen growth, hence further enhancing the skin firming and tightening result. This improves skin quality and dynamism. 
For optimum results in your case, I advocate. step 1 and 2 to fill and lift your face. Step 3 is optional and depends on your condition on review.
I hope this helps you.