Volume loss in my face and asymmetry in my jaw - Is filler the right option for me? (Photos)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. With hEDS, the key is choosing treatments that look natural and respect the way your tissue behaves. Many patients with hEDS can still do cosmetic procedures safely; the main concern is that skin and connective tissue can be more prone to stretch, bruise, or show irregularities if products are placed too superficially. If you dislike the look of a defined “cheek line,” you can ask for very subtle, low-volume cheek and temple filler placed deep—this avoids that sharp, overfilled look and instead restores gentle support that lifts the midface without looking obvious. Botox in the neck (the “Nefertiti lift”) can also help jawline contour in some people, but it won’t correct true asymmetry; it mainly relaxes platysmal band pull. I hope this helps!

Since adequate cheek volume is not only the major support for the under-eyes, but provides the natural lift and feminine projection of the upper outer cheeks, when there is volume loss there with the passage of time, we begin to see tear troughs, hollows and bags under the eyes, as well as accentuation of the smile lines below.
So properly injected, the use of a robust HA volumizing filler for the cheeks (in the hands of an experienced, board certified cosmetic dermatologist filler injection expert) can both diminish the smile lines and address the flattening and tear troughs under the eyes. What's more, this procedure should take about ten minutes to fifteen minutes to perform and typically gives rise to immediate results usually with little to no significant post-treatment downtime. So, while understandable, really no need to be so nervous. Hope this helps and best of luck.

Thank you for sharing your concerns so openly. Facial volume changes and asymmetry can feel especially overwhelming when you’re hearing different recommendations from different providers, and it’s very understandable to want something that still looks soft, natural, and true to you.

With your history of hEDS, certain considerations are especially important, and it’s good that you’re thinking carefully before choosing a treatment. Here’s how I would break it down:

Volume loss in the face
Cheek and temple fillers are common options for restoring gentle volume, but the technique matters. You mentioned not liking the “line” some people get along the cheek — that typically comes from filler placed too superficially or too far laterally. Done correctly and conservatively, cheek and temple filler can look very natural and simply restore the support you used to have.

Jaw asymmetry
Jawline filler or very precise contouring can help even out subtle differences, but in some cases, muscle activity plays a role. If one side of the jaw is more active, it can create an imbalance that filler alone won’t fix. In those cases, a small dose of masseter Botox can help improve symmetry without altering your natural structure.

hEDS considerations
With hypermobile EDS, some patients experience faster filler migration, delayed healing, or less predictable results — but this varies widely. Some tolerate hyaluronic acid fillers perfectly well.

Sculptra can be an option in some, but because it stimulates collagen, some providers avoid it in EDS due to theoretical risks of nodule formation or unpredictable collagen behavior. It’s not an absolute rule, but it does require extra caution.

Botox in the neck (“Nefertiti lift”)
This can help refine the jawline and soften downward pull from strong neck bands, but it won’t restore lost volume in the face. It works best as a complement, not the primary solution, for volume-related concerns.

What may make the most sense for you
Based on your description, a conservative, deep-plane hyaluronic acid filler approach to restore gentle volume — placed thoughtfully to avoid that sharp cheek line — can be very natural. This can be combined with small adjustments to the jaw muscles if asymmetry is partly muscular.

What matters most is working with someone who understands both facial harmony and the nuances of hEDS. A careful, minimal approach can absolutely give you subtle improvement without making you look “done.” If you’d like, I can help you weigh the pros and cons of each option more specifically.

Based on the nicely post to three photos, my first initial treatment would be an H a filler in multiple areas to gain some symmetry, but not over treat I would expect you would need minimum of two syringes of HA fillers to four syringes expect fees to range from two to $4000 best of virtual consult with. An additional Recommendation might be a tip rhinoplasty again best of virtual concert with.