I am 53 y.o. I have been utilizing fillers and Botox for about 4-5 years. At first 2 syringes of Restylane filler was utilized across the marionette strains and chin space however in a roundabout way on marionette line. I seemed very chin – y and not like myself in any respect. 4 months later Restylane outline and refine (2) had been utilized straight on proper and left marionette strains. The marionette strains had been corrected however my chin is now lopsided. The left facet of my decrease face and chin could be very noticeably bigger and longer than my proper facet (jowls). I even have a big bump on left facet of decrease face. I look horrible. I seem like a freak!
Requested my very respected plastic surgeon in NYC to appropriate it and he informed me that this bump is the commerce off to getting rid of the marionette strains. He stated if he dissolved it I would be again to sq. one with the marionette strains and to simply go away it and ultimately the bump will go down. I am beside myself. I would like to change to one other plastic surgeon who prompt that I strive silhouette elevate for he feels that no quantity of filler will ever get rid of the jowls.
How do you’re feeling about silhouette lifts for the decrease and mid face and he additionally prompt utilizing them to elevate my drooping brows? Do you employ them.? What’s your expertise with them or have you learnt of different physicians who use them and get good lasting outcomes? Thanks a lot. C.N.
First, I’d actually think about altering to an injectables skilled dermatologist. Right here’s why. Plastic surgeons are educated to do surgical procedure and most of them love surgical procedure. They’ve little or no coaching within the well being or illnesses of the pores and skin. Fillers, Botox/Dysport, lasers are usually not very attention-grabbing to them, and they’ve injectables of their workplaces as a approach to get sufferers within the door. Most moldable surgeons delegate the injectables to nurses whom they rent. There are just a few exceptions to this: surgeons who really love facial sculpting with non-surgical strategies. Usually, I don’t agree that fixing a filler contour downside places you again to sq. one, as your surgeon informed you.
It’s essential to do not forget that the sagging across the decrease mouth/chin space (mesolabial fold) typically comes from upstream. We lose quantity and pores and skin firmness in our higher faces and that exhibits up downstream. Usually one of the best answer is to each substitute quantity within the temple, higher later cheeks, and generally midface, and then have only a gentle contact across the mouth with filler. Or to pores and skin tighten and construct collagen with say Profound (deep RF microneedling), Sculptra, and CO2 laser and then fill extra calmly.
This typically provides a extra pure impact than a facelift, or simply pulling our pores and skin up within the mirrosr. 🙂
Fillers for Gentle Jowls
Normally fillers and injectables are sufficient to deal with gentle jowls (extra data on process, value and results of fillers in my article right here). When injected within the cheeks, Sculptra causes the physique to produce extra collagen. Sculptra is classed as a filler, but it surely’s completely different in that it’s a collagen stimulator additionally. It fills the cheeks extra and lifts the pores and skin within the decrease face and jaw line.
There are a lot of fillers that we use for lifting now within the hyaluronic acid household. For instance, Voluma, Restylane Lytft, Restylane Defyne, and so forth. At 54 years outdated, with out the profit of seeing you, it’s arduous to know the way a lot you would want. For my part, the important thing to the jowl space is to understands that the vectors (directional forces) that CAUSE the jowl are coming largely from upstream. Which means the pull and the elevate ought to comply with the pure curve of the face from the realm with the pooch on the jawline, up to the highest of the cheekbone (the zygoma). It sounds just a little like your physician is attempting to appropriate the issue from the chin solely. It’s true, some filler there could also be wanted, however actually not most of it. I actually hope this is smart. It’s arduous to clarify in 2D. 🙂
Fillers and Pores and skin Tightening Remedies for Moderate Jowls
The identical principals above apply for moderate jowls, solely extra so. Extra filler will likely be wanted to appropriate it. Count on to want roughly 4-Eight syringes that are greatest accomplished slowly and steadily over 2-Four appointments over 2-9 months. That is the bottom. Upkeep must be mentioned with you (for most individuals is 1-2 instances a 12 months). It depends upon so much of components like well being, weight acquire/loss, and so forth. It’s additionally typically good to add a pores and skin tightening remedy a couple of times a 12 months at this stage. Radiofrequency and additionally lasers on this website will assist tighten and elevate the pores and skin. We now have radiofrequency (RF) deep microneedling therapies that are more practical than Thermage or Ultherapy for moderate or severe jowls.
Treating Severe Jowls
It’s your decision to think about cosmetic surgery for severe jowls. However there are various who can’t threat normal anesthesia, or simply don’t just like the look aesthetically. Even severe quantity loss and jowls, generally nonsurgical will be very efficient. Normally a mix of radiofrequency pores and skin tightening, fillers, and lasers are used. A number of therapies are wanted. It actually depends upon bone construction and so much of different issues too sophisticated for this weblog. See an excellent aesthetic dermatologist for extra data on what choice is likely to be greatest for you.
For extra data on sagging pores and skin on the chin and jawline, and much more particulars on the procedures I point out right here, see my in-depth useful resource on it right here.
About your filler bumps and contour issues
Right here’s my in-depth useful resource about dermal filler issues just like the bump and lopsidedness you point out. It covers fixes, and how to stop in future. Learn extra right here.
Hope this helps,
Dr. Brandith Irwin