Best treatment for marionette lines, chin, and jowls? (Photos)

First, let me say that the various aesthetic problems here, namely sunken upper cheeks, pronounced smile lines, jowls along the jawline and marionette lines, are all every day problems seen in any active practice devoted to facial rejuvenation. Secondly, before fillers are simply tossed aside with "never helped," it would be important to investigate which specific fillers were used, how much of each, and for which areas was each used, as well as the exprience and expertise of the injector performing these injections. If a syringe or two of ordinary Restylane or plain Juvederm was used for the aforementioned problems, the results would be expected to be both unsatisfactory and short-llived. However, if a sufficiently HA filler were used for the cheeks, and another for the jawline and still a third for marionette lines and each was injected in the proper amounts and with the proper technique for the individual area, I would venture to say that the immediate nonsurgical transformation would elicit an on-the-spot "Wow!"
As to faddish and relatively expensive, here-today-gone-tomorrow so-called light and energy-based devices, like RF and fraxel lasers, the hard science to support their use lags woefully behind the heavy marketing to promote them. So, "buyer beware!" when it comes to these. You would be wise to make sure that you consult with an experienced, board certified cosmetic dermatologist.

Hi and thanks for your question!Microneedling and radiofrequency would be a great option to tighten the area in your lower face and jowls. Based on your photos, I would recommend treatment of both face and neck for the best results.Please be aware that best results will be obtain with a series of 3 monthly treatments, with best results at 6 months.I would also consider adding to your microneedling a treatment with Sofwave, which uses ultrasound therapy to heat the dermal layers, causing stimulation of both collagen and elastin under the skin, to provide skin lifting.Given that there is heaviness in the lower face, I would not necessarily recommend fillers at this time. While fillers can help to "turn up" the corners of your mouth (which you mentioned you wanted treated), I don't think you would be fully happy if the lower face heaviness is not properly treated.Hope this helps!