Suggestions for non surgical lower face improvement? (Photo)

Question

I'm 38 and am very unhappy with how my lower face is aging. I've heard very conflicting things regarding thread lifts, fillers and even treatments like Morpheus8. I had a halo and BBL treatment last year and as minimal improvement. I've also had filler, several syringes and also didn't see much improvement but am being told I need more. At the cost of 700-800 plus I might as well just save it for my facelift later on in life.

Nelson Lee Novick, MD · Answer

I am hardly surprised that relatively expensive, energy-based gizmo treatments did not work. I have been cautioning my regular readers for years already that the hard science to support the use of these devices lags woefully behind the heavy marketing hype and social media buzz to promote them. Sorry. I gave up thread-lifts years ago. The results do not last as long as promised and the rates of adverse reactions, such as skin dimpling, divets, extrusion of the threads, infections, etc., are way to high.  From the photo provided, there appears to volume deficit in the lower face and loss of definition of the jawline that can be quite easily addressed with the use of an appropriately robust HA filler. Likewise, the smile lines and prominent marionette lines can be improved with the appropriate injection technique of the proper HA filler to address these issues. I would strongly suggest that you make sure to be consulting with an experienced, board certified cosmetic dermatology filler expert. Frankly, filler treatment for all the areas noted above by an experienced injector should take no more than about 30 minutes to perform with immediate, meaning on-the-spot results. So, once again, I would suggest that you make sure to be seeking evaluation and treatment by an expert physician. And, one more piece of advise. If you go into a consult asking upfront for a particular gizmo or threadlift, etc. treatment, you may unfortunately get what you ask for. Hope this helps and best of luck.

Alexander Golberg, MD, DO · Answer

The results of non-surgical lower face treatments depend greatly on the quality of materials used and the expertise of the provider. High-quality threads, fillers, and bio-stimulating agents can create natural and long-lasting improvements, but their success relies on proper placement and technique. An experienced provider will assess your unique facial structure and aging concerns, tailoring the treatment to achieve balanced, natural results.
In my practice, I specialize in combining advanced techniques with premium materials to enhance the lower face. My signature approach includes using threads for lifting, PRF to stimulate collagen and improve skin quality, and bio-stimulating agents to restore a youthful appearance over time. This comprehensive method often postpones the need for surgery and delivers results that are both effective and subtle.

Jeffrey S. Rosenthal, MD · Answer

The Endolift Laser is an FDA cleared procedure that uses a thin fiber placed through tiny pin holes in the skin to stimulate your collagen and tighten lax tissues.  This is an ideal procedure to rejuvenate and contour loose tissues.

Anil R. Shah, MD · Answer

Hello, my name is Ranen and I work at Shah Aesthetics.  The thing about non surgical treatments, you are going to get non surgical results. You will get some improvement and will need multiple treatments as well.  I think doing RF needling such as morpheus8 or Forma,  will help to tighten and lift along with some botox in the lower half of the face may help.

Rodney A. Green, MD · Answer

You have developed some early jowl formation. This is also starting to form a "marionette" appearance. Fillers can certainly be used to mask this to some extent. Tightening of the skin however would be the optimal treatment. Tightening of the skin of the cheek and jowl and also treating the deeper skin and fat of the jowl with Morpheus8 device would be helpful.
Ultimately a facelift will be the solution to the problem.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Laurie A. Casas, MD, FACS · Answer

Hello and thank you for your question. A combination of filler as well as Ultherapy would address your concerns. Filler to address the volume loss and Ultherapy to tighten and lift the skin. Ultherapy works by administering ultrasound energy to specific depths of skin and muscle with precise ultrasound guidance, which causes tissue tightening and collagen production.

Ryan Welter, MD · Answer

Thank you for your question! Non-surgical options for improving the appearance of deep lines and laxity in the lower face can be very effective, depending on skin type and the amount of excess tissue. Given your experience with minimal results from fillers, alternative treatments such as advanced RF microneedling (like Morpheus8 and newer-generation devices) or CO2 laser treatments might be a more suitable option. These treatments work to tighten the skin, boost collagen, and improve texture. While fillers add volume and help contour, they might be less effective alone for addressing deeper skin laxity or lines.

If you’re concerned about investing in ongoing treatments, it’s worth discussing a combined approach. For instance, RF microneedling could provide structural tightening, while transdermal RF (non-needle) treatments could help maintain those results comfortably over time. If skin laxity is moderate to severe, a more invasive approach, such as a surgical facelift, could ultimately be more cost-effective and deliver longer-lasting results. Consulting with an experienced practitioner will help clarify which combination or approach would best meet your goals.

Nuket Eroglu, MD · Answer

Hello, as far as I examine for your face, the looseness in the tissues is at the forefront. That's why; I will first recommend for you Thermage FLX method. Rope hanger is a choice; which is incorrect. Straps are visible on thin and sagging skin. First of all, an increase in skin quality and firmness should be achieved. Hyaluronic Acid fillers should not be used on your face. Hyaluronic Acid fillers weigh down; loose skin and cause downward volume of the face. BBL does not provide any noticeable benefit. Actually, what you need is Thermage FLX treatment. Thermage FLX will maximize for your texture quality in a serious way. It will create non-surgical face lift on your face. It is confirmed and approved by FDA in this regard. I advise for you Lanluma technique; in addition to this treatment. Lanluma is a PLA molecule. It includes liquid face lift. It gives youth and firmness rather than fullness and renews the skin. With the combination of these two treatments, your skin is gradually rejuvenated from the inside and outside zones, and the final effect after six months would be permanent for many years. I recommend Radiesse for your Midface, Nasolabial and Marionette lines. Radiesse, which is a Calcium Hydroxyapatite molecule that offers you a lifting effect as well as a slight plumpness. I am sure that you will get an excellent results with these combination.

Camille Cash, MD · Answer

You can consider FaceTite.  This minimally invasive procedure uses RF technology to tighten the skin on the lower face and neck.  No general anesthesia is required.  The results can be enhanced by adding Morpheus8 treatments.  See my website or a provider near you to learn more.

Suggestions for non surgical lower face improvement? (Photo)

Answers (13)

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