Is there a non surgical solution for an uneven jaw line/pre-jowls? (photos)

Question

Recently have started to notice that my jaw is un-even. I suffer from TMJ And have had Dysport before in my masséter muscle, but now wonder if my uneven jaw line is actually related to the bone structure of my jaw. Also, on my right side (left in photo) I’m starting to see pre-jowls and some marionette lines and general sagging of the skin. Is there a non surgical solution to give my face more symmetry?

Jason Emer, MD · Answer

Symmetry of the face created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Implants or fat are permanent alternatives. For skin tightening of the face, a combination approach will give the most improvement. I recommend J Plasma, lasers (Fraxel, Clear + Brilliant, Co2), microneedling/prp, ultherapy and rf treatments. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Michael A. Zadeh, MD, FACS · Answer

Everyone is asymmetric. In certain people this asymmetry is more noticeable. Attaining perfect symmetry is virtually impossible, however, it can be improved. Non-surgical options for the jowls and jawline include a combination of neuromodulators (Botox, Dysport, Xeomin), Fillers, Sculptra, Kybella, Ultrasound, and Radiofrequency treatments. Make sure you see an experienced physician provider for an in-person consultation and evaluation to determine which combination of treatments would be best for you. Best wishes.

N. Bill Aydin, MD · Answer

Thank you for your question. Based on your photos I do not see any prominent pre-jowling or marionette lines. The quality of your skin seems to be in good shape as well. Sometimes, filler can be injected into the jawline to give a more structured and defined appearance but I would always consult an experienced injector in order to get the best results.

Gerald Pierone Jr., MD · Answer

Hello and thanks for posting.
One of the best uses of facial fillers is to restore symmetry. This is true for many areas of the face, including the jawline. Sometimes a combination of facial fillers and Dyport may produce the best result, especially if TMJ and masseter muscle enlargement are playing a role. 
  
I hope that this information helps and best of luck to you!

Lawrence Janowski, MD · Answer

Yes, fillers should be able to do an excellent job in creating more symmetry in the jawline and pre-jowl area.  A firm filler such as Restylane Lyft or Radiesse should be considered.

Shaun Patel, MD · Answer

It's hard to tell if the asymmetry is related to the underlying bone or masseter muscle enlargment. An in person evaluation would help. If the asymmetry is related to the masseter muscles, then a neuromodulator like Botox or Dysport should help. The prejowls and marionette lines maybe treated using fillers.

Sami Nizam II, MD, DMD · Answer

I can indeed note your asymmetry (I myself have one). This is very common in the population and no one is exactly symmetric. Google "mirror image of face" and you will see some neat examples of this. Looking at your picture it looks as though you have had more growth of your mandible on the left. This accounts for your chin being shifted to your right. If I had to bet when you smile you would also notice your left upper teeth are slightly lower (your maxillary growth will usually mirror your mandibular growth). You do state you have a temporomandibular disorder. My first step would be to make sure you don't have an active issue at the joint level that is accounting for your asymmetry. After that has been ruled out there are a few options. The easiest is a filler like Voluma that will last 1-2 years. This can give you a nice opportunity to sample out how you like the asymmetry correction. If its amenable to you you could then move to a more permanent solution. These two options would be orthognathic surgery or custom implants. As far as your pre-jowel sulcus/marionette region I would leave that alone for the time being. These changes are very minor. Hope that helps.

Dr. Nizam

Dr. Nizam

Patricia Faraz, MD · Answer

Hello Lesoleilmoon,I am not seeing any asymmetry to your jaw line or any pre-jowls or marionette lines. Dermal fillers can be used for sculpting the face and defining facial structure. My recommendation to you is to keep the skin stimulated and rejuvenated to prevent the skin from prematurely aging. Best to you,

Norman Gonzales, MD · Answer

There are a few possibilities.  You have had dysport into the masseter.  One side may have more muscle mass than the other.  Treatment would be adjust the dysport dose.  The other possibility is your bone structure.  For the sagging skin, consider fillers.  Unfortunately, it's difficult to tell by looking at a picture.  An exam by an experienced provider would be needed to evaluate the underlying cause.

Is there a non surgical solution for an uneven jaw line/pre-jowls? (photos)

Answers (9)

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