38 years old - how can I treat sagging skin at the corners of the mouth? (Photos)

Question

It’s gotten really bad. I’m 38 and I recently got 7 vials of filler in the cheeks to lift the sagging and improve the volume. It looks good but the problem around the drooping mouth skin never left! I’ve had many professionals say I need filler but it just doesn’t seem to help. this seems to be a medical mystery so I brought it here. I think I need something surgical to lift but I really don’t know what. Please advise. Thank you!

Nelson Lee Novick, MD · Answer

This is a very, very common problem treated with robust HA Fillers practically every day in an active cosmetic dermatology practice. The jawline sagging and lack of definition can be easily treated, usually in one treatment session, using a robust HA contouring filler injected with the proper technique along the jawline and lower third of the face. This will generally, secondarily help to improve the Perioral folds that disturb you. Finally, a robust HA lifting filler injected properly can directly address these folds. 
In the hands of an experienced, board certified cosmetic dermatology filler injector expert, total treatment should take approximately twenty minutes, with immediate results and little to no significant post-treatment downtime. You would be wise to make sure to consult with an experienced, board  certified cosmetic dermatologist injector expert and best of luck.

Julian De Silva, MD · Answer

Thank you for asking this, and it is not a medical mystery, though I understand why it feels like one. The area around the corners of the mouth droops because of tissue descent and skin laxity, not primarily volume loss. Filler treats volume. That is why seven vials in the cheeks improved your cheeks yet left the drooping at the mouth untouched: the problem there is not emptiness but laxity, and additional filler weight in nearby tissue can even accentuate it slightly.

At 38 a facelift is usually an early conversation, but you are right that lifting, not filling, is the direction that addresses this specific complaint. What matters now is a careful in-person examination: how much true laxity exists, what the jowl and marionette area do when your face animates, and whether the change justifies surgery now or in a few years.

From your description, I would pause on further filler in that area until a surgeon who works on faces has examined you properly.

38 years old - how can I treat sagging skin at the corners of the mouth? (Photos)

Answers (2)

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