I was looking to improve my imbalanced facial features and 'tired appearance'? (Photos)

Hello everyone. While I have have never been 'pretty', I have been looking to make some improvements, mainly to balance my facial features. I was considering tear trough injections and cheek injections. I was also considering getting Botox masseter injections because of my square face and maybe a chin implant to make my face shape less masculine. I would consider surgery , particularly a blepharoplasty, but I have limited PTO. Am I being reasonable?

Doctor Answers 13

Options for facial enhancements with lower third facial fullness

Dear facialmakeover:Thanks for sharing your photos. Please don't be so hard on yourself! You have some great facial features and those you are concerned about can be improved. Budget and recovery time are considerations for the options available. Positive features:
  • Well balanced facial "thirds"
  • relatively thin straight nose
  • unlined forehead and eyes with high brows
  • full lips and balanced chin
  • thin neck without muscle prominence.
  • even skin coloring and well textured skin without acne, large pores nor blemishes
  • I like your idea of a blepharoplasty because of the very long brow to eyelid distance; botox (by a experienced and skilled injector may improve this as well). 
  • Cheek fill will definitely rebalance the cheek to jaw width concern (again using a talented injector). Depending on your masseter volume, Botox may reduce this as well. Micro-lipocontouring has served me well many times for lower cheek and jowl fullness and the fat may be used as fat graft to the cheeks. Your may option for a "structural" filler such as Radiesse on the cheek bone and / or "volumizing" filler such as Restylane and Juvederm for soft tissue filling and widening. 
  • Skin rejuvenation toward continued skin tightening with ZO Skin Health by a Certified Team. 
Please consider a consultation with a Board Certified Plastic Surgeon experienced in surgical and non-surgical cosmetic enhancements. I hope this is helpful! All the best. 

Baltimore Plastic Surgeon
4.8 out of 5 stars 66 reviews

Fillers and botox

You obviously need to be seen in person and fillers may be a good idea to enhance areas of deficiency.  Botox may help your masseter if it is large.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

I was looking to improve my imbalanced facial features and 'tired appearance'?

Thank you for your question and photographs and I think you have attractive facial qualities.  Masseter hypertrophy can be corrected by some degree of diet modification, avoiding chewing gum for instance, but also by the use of Botox to atrophy the muscles a small amount.  Dermal filler injections into your tear troughs and cheeks can be done and since your chin is not very small fillers can be placed here as well.  See an ASPS board certified plastic surgeon in consultation to discuss the best treatment options. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Facial asymmetry

What you are seeking is not unreasonable. From a procedure timing standpoint, I would suggest that you, with your facial plastic, determine that the fullness on the right side of your face is due to masseter hypertrophy. If so, then I would suggest starting with Botox injections into the masseter muscle to see how much resolution of the fullness of the (R) side of the face you can achieve. Once you're happy with that, then fillers in the (L) cheek can be done to equalize the cheeks.You might also inquire about Voluma injections to the cheek bone areas (minimal) and even to the temporal region (minimal). The chin implant can be done in the same time frame as the masseter injections.

Robert J. Smyth, MD
Cincinnati Facial Plastic Surgeon
3.7 out of 5 stars 10 reviews

Change facial features

You are actually attractive and improvements can be made but you don't need that much. filler in the nasolabial fold and maybe in the cheeks  would do the most/ a chin implant would also help the contour. Be sure you see a board certified plastic surgeon

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Botox and fillers

I think you are definitely being hard on yourself. You have some very nice facial features; for example, your full lips. I would consider a combination treatment with Botox and fillers to help contour your face. Juvederm Voluma into the midface (cheeks) and chin and Botox injection into the masseters will help make your face more oval. Some filler could also be placed in the tear troughs to help with the dark circles. I recommend seeing an experienced injector for an in-person consultation.


facialmakeover, don 't be so hard on yourself; you have a lot of good things going from what I can see. However, if you really want to try something consider fillers to your cheeks. Your lids are fine for now. A chin implant would be of benefit. See an experienced facial specialist. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.8 out of 5 stars 44 reviews

Minimally invasive is the best approach

Thanks for the photos.  I think conservative filler injections to the tear troughs, cheek and chin in combination with a light Botox treatment would achieve a natural looking, pretty result.  I'd avoid surgery - I don't think it's necessary.  Best of luck.

Chaneve Jeanniton, MD
Brooklyn Oculoplastic Surgeon

Chin Implant and Injectables

Hello and thank you for your question.  I think that a chin implant, which can be placed thru a nearly invisible incision, would balance your lower face nicely, especially the side profile.  This would also likely soften the appearance of your masseter muscles and narrow the chin.  I think that a HA filler into the tear troughs and upper cheeks would improve the "tired appearance".  You would need to consult with a board certified plastic surgeon about the blepharoplasty; you don't appear to have an excess of skin on the upper or lower eyelids, but this can be tough to see from pictures.  Good luck!

Ryan Marshall, DO
Missoula Plastic Surgeon
5.0 out of 5 stars 6 reviews

Face Lipofilling

Dear Patient, First of all thank you very much for the question. As plastic surgeon I would like to suggest you to get a Face Lipofilling. The procedure is very simple: your own fat will be taken with liposuction and it will be injected to your zygoma bone area and chin bone area for to make a perfect shape of your face. This procedure will help your face to have more feminine amazing lines. Since you do have limited PTO, you will return to your normal social life after 1 week, face will be swollen. Also Botox treatment can be done for your forehead areas wrinkles if you an active user of mimics.I do not recommend you to have a blepharoplasty since you do not have any problems with eyelids.You have beautiful form of lips so you do not need any improvement there also.Good luck with your decisions and greetings from Istanbul, TT.

Tunc Tiryaki, MD
Turkey Plastic Surgeon
4.7 out of 5 stars 6 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.