Droopy lower face - would Sculptra help or do I need something more aggressive? (photos)

Relax. In experienced hands, the use of appropriate, robust HA lifting and volumzing fillers can reshape and recontour the face, resupply volume and diminish jowls in less than a half hour with typically immediate "Wow!" results. I just did that for my next to last patient last night. A filler, such as Restylane Lyft, in the cheeks, can not only create a more ideal, heart-shaped feminine face, but treat the mid-face flattening and also secondarily improve smile lines and even to some extent the drooping at the corners of the mouth. A volumizing filler, such as Voluma XC fanned from the angle of the jaw would serve to straighten and define the jawline (i.e. diminish the jowl along the jawline) and further straighten the angles of the mouth. Make sure to consult an experienced, board certified cosmetic dermatologist and ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

When it comes to treating the face, a combination of treatments usually leads to the most natural outcomes. As we age, volume loss is caused by a combination of factors including bone loss, fat pad migration/thinning, and skin texture changes (loss of collagen and decreased elasticity). Each of these issues should be addressed in order to achieve natural looking results. Replacement of volume loss with fillers/sculptra helps to recreate the bone/fat pad loss that occurs with aging. Energy-based devices such as lasers, microneedling, radiofrequency help to tighten the skin and restore some of the lost collagen and elastin. Using one or some of these treatments will address the drooping that you mentioned in your question. A good skincare routine including retinoic acid, exfoliants, vitamin c, a good moisturizer, daily sunscreen will also help to improve your skin quality and texture. You will be surprised how much implementing some of these changes will do for your skin!

Sculptra over time (like 6-9 months & many sessions) helps grow your own tissue. In my over the Real Self internet opinion is not exactly what you would need. I recommend a mini FaceLift with SMAS plication, nano fat grafting or HA fillers. Expect fees in the $10,000 ranges.