[Doctor's Explanation] Lower facial sagging can be improved "without surgery" | 3 case studies showing changes in the corners of the mouth and nasolabial folds

Introduction | Lower facial sagging is caused by "shadows" that make you look older.

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Lately, I've been bothered by sagging around my mouth and a general feeling of looseness in my lower face... But I'm a little scared of surgery. Are there any ways to improve it without surgery?

Director Shiramizu

Yes, it is possible. Lower facial sagging can be improved without surgery by skillfully combining thread lifts, hyaluronic acid, and Botox. Today, I will explain the approach while looking at three actual case studies.

When you start noticing things like "my nasolabial folds are getting longer" or "the corners of my mouth are starting to sag," the first thing that might come to mind is a surgical facelift. However, nowadays, the mainstream approach to reshaping the lower face involves combining non-surgical treatments such as thread lifts, hyaluronic acid injections, and Botox.

The important thing is not "which procedure to receive," but "what type of sagging you have." In this article, we will introduce the philosophy and treatment plans for non-surgical lower face improvement through the case studies of three patients who actually visited Elm Clinic.

*This article is a revised and expanded version of the content from the YouTube video.

The real reason why sagging in the lower face makes you look older

When people start noticing sagging in their lower face, many describe it as "their skin has lost its firmness." However, the real reason why sagging makes you look older is not the skin itself, but the "shadows" created by the unevenness of the contours of your face.

Director Shiramizu

Indentations simply create shadows, resulting in dark areas on your face. Creating a contour with as few bumps and curves as possible, allowing light to fall evenly, is key to looking youthful.

The cause of sagging is not the "skin" itself, but rather the "ptosis of the fat compartment."

Facial fat is naturally divided into several compartments, each kept in its proper position. As we age, the ligaments that support these compartments loosen,The fat shifts downward from its original position..

This creates "hollows" in areas where fat has decreased, such as around the eyes and temples, and "bulges" in areas where fat has accumulated, such as above the nasolabial folds. This contrast in contours casts deep shadows on the face, making you look older.

Sagging skin is a complex issue involving "fat, muscle, bone structure, and skin quality."

Lower facial sagging is not caused by a single factor, but rather by a combination of several elements.

Therefore, a single treatment is often insufficient, and it is necessary to combine treatments depending on the cause.

Three non-surgical treatment approaches to improve sagging in the lower face

Treatments to improve sagging in the lower face without using a scalpel can be broadly categorized into three types. Understanding the role of each will help you see what your specific sagging needs.

Thread lift | "Lifting" sagging fat

Thread lifting is a treatment that involves inserting special threads under the skin to physically lift sagging fatty tissue. A major cause of sagging in the lower face is the sagging of the fat compartment.A central role in resetting the foundation of the outline.I will carry the.

Hyaluronic acid | Fills in depressions and smooths out unevenness

It plays a role in filling in hollows around the eyes that cannot be completely addressed by thread lifts alone, and in reinforcing the jawline. It's easiest to understand it as the "additive aspect" of sagging treatment. By injecting it into the subtle shadows that remain after lifting, and in areas where sharpness is needed at the tip of the chin, it connects the contours into a single, smooth line.

Botox | "Suppresses" muscle tension

If the masseter muscles (jaw muscles) are well-developed and the face appears square, thread lifts alone may not be able to reduce the size to the desired extent.First, reduce muscle volume with Botox, then refine the shape with thread lifts or hyaluronic acid injections.That's the standard approach. The key is to do it in several sessions rather than all at once, as part of a long-term plan.

Three Patterns of Non-Surgical Lower Face Improvement: Case Studies

From here, we will look at treatment plans tailored to each type of sagging, using the case studies of three patients who actually visited Elm Clinic.

Case 1 | Female in her 40s | Fat sagging type (thread lift + hyaluronic acid injection)

A woman in her mid-40s came to our clinic seeking treatment for sagging in her lower face. Her facial contours were uneven, there was a slight hollowness around her eyes creating shadows, and her nasolabial folds appeared somewhat elongated.The cause of sagging is the ptosis of the fat itself.As a result, the fat shifted downwards from its original position, creating a "mixture of unevenness" in the area, including hollows around the eyes and bulges above the nasolabial folds.

The treatment began with a thread lift to reposition the sagging fat and refine the contour. To fill in the hollows around the eyes that couldn't be addressed by the thread lift alone, one syringe of hyaluronic acid was injected into each eye, and another syringe was added to make the jawline appear sharper.

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It's amazing how much your appearance can change just by having a different jawline!

Director Shiramizu

That's right. By using thread lifting to raise the "surface" and hyaluronic acid to repair the "points" of indentation, the previously disconnected light reflections are connected into a single line. The biggest improvement is that the shadows of the nasolabial folds have disappeared.

Case 2 | Female in her 20s | Masseter muscle development type (Botox → Thread lift + Hyaluronic acid injection, 9-month long-term plan)

A woman in her 20s wanted to make her face smaller because it looked large. Initially, she wanted a thread lift, but after the examination...The location of the fat has hardly changed, and the tension of the masseter muscle (jaw muscle) remains unchanged.That was the main reason why the face appeared larger.

Therefore, we devised a phased plan to start with masseter Botox injections, reducing the volume of the masseter muscles over approximately one year in 3-4 sessions. After the width of the lower face was sharpened, we then used thread lifts to lift the fat in the cheeks and hyaluronic acid injections in the chin to create a V-line.This case took 9 months to bring us to this point..

Case 3 | Male in his 40s | Beginner in cosmetic medicine (starting with skincare and progressing gradually)

This was a consultation from a man in his 40s with no prior experience in cosmetic medicine, who said, "I don't know what to do, but I want to look somehow better and younger." This is a common pattern among men.

Instead of starting with an invasive treatment like a thread lift,First, start by reviewing your skincare routine and getting your beard removed to improve the foundation of your skin.I prioritized that. I started with a mild retinol and gradually increased the concentration, and when I felt my skin was getting clearer and my motivation increased, I moved on to thread lifts and hyaluronic acid (around the eyes and chin).

In the case of men, creating a contour that is too smooth, like that of women, can sometimes give an androgynous impression. Therefore, the thread design is mainly placed on the outer edges, and the jawline is kept with "a certain degree of sharpness" to maintain a masculine look.

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I didn't know that thread lift designs are different for men and women.

Director Shiramizu

If a man's facial contour is too smooth, it can look unnatural and lack strength. We adjust the amount of hyaluronic acid injected and the way the threads are drawn according to the man's gender and preferences.

The concept of "total balance" that you should know when choosing a treatment.

In recent years, with the spread of social media and the internet, there has been an increase in patients coming to our clinic specifically requesting certain procedures, such as "aristocrat fillers" or "nasal hyaluronic acid injections." However, from a doctor's perspective, there are many cases where these procedures are not necessarily the optimal choice.

Let's take "I want to make my nose look smaller" as an example.

Many patients come to our clinic seeking treatment for "aristocrat fillers" (hyaluronic acid injections into the base of the nasal wings) because they want to make their noses appear smaller. However, the desired changes are often not achieved with aristocrat fillers.Making the bridge of the nose higher or injecting hyaluronic acid into the chin to refine the E-line can make the nose appear smaller in the end.There are quite a few cases.

Facial beauty is achieved through the interrelationships of its various features. Often, adjusting the overall balance of your face, rather than trying to change just one part, can make a particular feature less noticeable.

It's okay to have a "rough consultation" during counseling.

Director Shiramizu

You don't need to book an appointment by the name of the treatment. Just tell us your concerns, such as "I want to reduce the appearance of my nasolabial folds" or "I just want to look younger," and we will suggest the most appropriate treatment for you.

At Elm Clinic, we use a skin diagnostic device to perform an objective skin analysis during your initial consultation, quantifying conditions such as sebum, dryness, and pigmentation, and then create a treatment plan based on that.By considering both subjective opinions and numerical data, it becomes possible to make more accurate proposals. will be important.

Frequently Asked Questions about Lower Face Sagging Treatment

How much downtime is there?

It varies depending on the procedure. Thread lifts may cause tightness and swelling for 1-2 weeks, hyaluronic acid injections may cause bruising for about a week, and Botox has virtually no downtime. If you combine multiple procedures, they can be scheduled separately to suit your needs.

How long does the effect last?

The effects of thread lifts typically last from six months to a year and a half, depending on the type of thread used. Hyaluronic acid fillers last from six months to two years, depending on the product and area treated. Masseter Botox fillers typically last from three to six months. With continued maintenance, you can maintain a more natural-looking result.

Which treatment should I start with?

It depends on the type of sagging. If the main cause is fat sagging, we start with a thread lift; if the main cause is tension in the masseter muscle, we start with masseter Botox. The order of treatments is determined according to the cause. It is recommended to start by determining the cause with a free consultation.

Can men take the test?

Absolutely. We've seen a significant increase in male patients over the past five years. For men, we use a different design than for women, focusing on lifting the outer edges while maintaining a strong, defined look.

*The effects may vary from person to person.

Summary | The essence of youthfulness is "a contour where light is evenly distributed."

Lower facial sagging is not solely due to age, but is caused by a combination of changes in fat, muscle, and skin texture. Therefore, it's possible to improve it without surgery by combining thread lifts, hyaluronic acid injections, and Botox.

Whether your concerns are simple, like "I want to reduce the appearance of my nasolabial folds" or "I just want to look younger," Elm Clinic offers personalized consultations with doctors who will propose a treatment plan tailored to your needs.

• thread lift
• hyaluronic acid
• Elabotox

*The effects may vary from person to person.
*The treatment costs and side effect information for the cases listed in this article are provisional values. Please replace them with confirmed information.
*The case images are placeholders. Please replace them with actual case images.