I am interested to find the best procedure to improve the lower part of my face?

I am posting photos of my face. The first ones will be how it looks now, and the other show what it looks like when I pull up on my cheeks. I like the way that looks much better. My face looks tired and in symmetrical. I would like the lower half of my face to be firm with more volume in my cheeks. I am getting my nose done next month. I wanted to get a lower face lift, but not doctor in Vancouver will do the procedure since I am only 26 years old. What do you recommend.

Doctor Answers 5

Interested to find the best procedure to improve the lower part of my face?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years. From the photos, your cheeks are a bit flat anteriorly (in the front) with a slight amount of excess fat in front of the cheeks as well as a weak chin.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. I have performed many Chin Augmentations using chin implants for over 30 years.  From the photos, your chin is weak.  A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. 

 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.  Think of facial beauty as something that "must" address all layers of the face including the skeletal structure of the cheeks and chin, the overlying SMAS muscle, amount and position of subcutaneous fat and finally the degree of skin laxity. It's an "urban myth" that pulling tissues over flat cheeks and a weak chin can create a beautiful or handsome face. Similarly, dermal fillers or facial implants alone can't lift and remove excess skin from the face and neck. Natural looking beauty is created by the aesthetic vision of what tissue layers need to be adjusted by what technique and amount.Hope this helps. A non smiling photo of your face from the front would identify if you have early "jowl" formation.  I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties that had early formation of "jowls".    If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.  My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

When is too young to start facial rejuvenation?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Futurebaby

The question you ask is a very reasonable one, but it is difficult to answer as there are no accompanying images with your question.  Without the the ability to post facial images for others to see, as some people are self-conscious posting these things on the Internet, I would recommend that you obtain the opinions of several providers in your local area.  At this information helps you as you make the right decision for you.

Be healthy and be well,

James M. Ridgway, MD, FACS

James M. Ridgway, MD, FACS
Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Best procedure to improve the lower part of face in 26 year old?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Dear Futurebaby, 26 is a little young for a face lift especially when there are good alternatives. Fat Transfer for the cheeks and ThermiTight for the lower face and neck.

Curtis Perry, MD
Downey Facial Plastic Surgeon
4.8 out of 5 stars 19 reviews

Lower Face Drooping -- Sculptra, VASER/ThermiRF, Neck Lift, Thermage/Ultherapy/Exilis Ultra, Kyeblla

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I suggest seeing an expert for an evaluation, sculptra, VASER/ThermiRF and ultherapy/thermage do great to this area when you are younger to avoid neck lifting at early ages.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 204 reviews

Cheek implant candidate for more volume in the cheeks

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
At age 26, a facelift is not  recommended.  When patients have a flat maxilla and a flat cheek profile and desire more volume in the cheeks, cheek implants offer a permanent alternative to volumize the cheeks.  Cheek implants are manufactured in a large variety of sizes and shapes, are composed of Silastic, and are placed through an intra-oral approach under a brief general anesthesia as an outpatient surgical procedure.  In our practice, we use Implantech malar and sub-malar implants for the last 25 years. For more information, diagrams and many before and after cheek implant examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 155 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.