Best Treatment for Sagging Mouth and Wrinkles? (photo)

You have asked an excellent and challenging question. BOTOX® Cosmetic is a wonderful solution for the forehead, but it does need to be repeated every 4 to 6 months. After several years, you have in effect paid for a surgical procedure. Around the corners of the mouth, non-surgical correction is best done with fillers that also generally last no more than 6 months. The average well-done lower face lift (not a mini lift) should last on average close to 10 years and will also address the jowls. This is a highly individual decision that really can only be fully evaluated during an in-person consultation. At age 44, many people will try to hold off on having surgery by using BOTOX and fillers for a few years, but surgery does give a better long-term solution for the mouth. It is hard to talk economics without a one-on-one consultation.

The key to a natural appearance is to restore a youthful facial shape.  Due to the aging process, it appears that you have developed lower facial jowling, volume loss in lower eyelid area and hollowness in the temple region.  This has reversed the youthful heart-shaped appearance to a slightly more rectangular shape.  As a result, based on the photo that you have shown, I would recommend a customized lower facelift with a more vertical vector, fat grafting or fillers for temple and lower lids. This approach would restore a beautiful and natural youthful appearance. As always, a full in person examination would give your surgeon the best opportunity to determine an exact plan.