Most effective treatment for 'pre-jowls"? (photos)

Question

I'm 33 years old- have noticeable nasolabial fold and worse marionette line that is severely bumming me out. It's worse on the side of my face that I sleep on for sure- That being said sleeping on my back isn't realistic. Undergone a lot of stress in the last 4 years (who hasn't) and don't want to be reminded every time I look in the mirror. Looking for treatments that don't require much maintenance as getting an appointment and keeping it is treacherous. What are my best options given my age?

Jason Emer, MD · Answer

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting,  and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Nelson Lee Novick, MD · Answer

Front face and profile photos would have been helpful. However, from the photos provided, it would appear that in the hands of an experienced physician injector, all of the issues could be treated in one treatment session. A robust HA filler for the upper outer cheeks would go far to address the apparent volume deficit in the cheeks, which is contributing significantly to the smile lines, drooping at the angles of the mouth, and even to some extent the developing jowls along the jawline. There is some suggestion of volume deficit in the chin. If so, simple filler augmentation of the chin would not only better harmonize chin projection with that of the nose and lips in profile, but would likely secondarily improve, straighten and define the jawline. All of the above can be done in about 20-30 minutes in experienced hands. I have a patient coming in this afternoon, as a matter of fact, for precisely these issues and treatments. Make sure to consult with a board certified cosmetic dermatologist and ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

Zoran Potparic, MD · Answer

Considering mild nature of your problem with NLF and M lines, best solution would be HA based fillers. Injection of fat grafts is other option which did not show to be any better and longer lasting than fillers in this particular area. Good luck.

Darryl J. Blinski, MD · Answer

Combination of mini facelift with HA fillers or fat grafting using nano fat. Best to seek in person consults.
Expect fees in the $8,000-$10,000  ranges.

Gerald Wittenberg, MSc, DMD (retired) · Answer

The actual 'grooves/lines' typically result from a lack of bone support, especially at your age. For example, you lower jaw/chin is underdeveloped so that the 'corners' of the mouth lack some support resulting in the appearance you dislike. They typically worsen with age as the soft tissue thins. Consider evaluating the underlying bone support in each area of concern with a qualified surgeon

Most effective treatment for 'pre-jowls"? (photos)

Answers (5)