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Dr. Dean Kane Answers Question Regarding Asymmetric Facial Aging Options

Q: Would Botox or filler be best to either lift the one side or fill my asymmetrical top lift? Early and asymmetric facial aging options: fillers, fat, lipo-contouring, tightening, lifting.

A: Thanks for sharing these photos. I see your concerns and they are due to the natural asymmetry of us, humans, and the beginnings of facial skin laxity.  Such tissue drooping starts at 30 years old when collagen skin repair diminishes and passive skin aging relaxes downward. The web of fibrous compartments under the skin loses fat, stretches, separates and elongates forming 5 growing “waves” of skin at points of attachment, developing:

  • hooding along the eyes,
  • lower eyelid / cheek junction or tear trough / nasojugal fold
  • nasolabial fold,
  • lateral mouth commissure and marionette folds,
  • jowls and neck.

Without the opportunity for an in-person consultation, I would recommend that you discuss your concerns with a Board Certified Plastic Surgeon who provides non-surgical, minimally invasive and surgical alternatives.  Based on these limited photos, I might suggest (in no specific order):

  • Non-surgical skin tightening with retinoids and chemical or laser tightening
  • Fillers including fat grafting of the upper cheeks and folds
  • Micro-lipo contouring of the jowl / lower cheek and fat grafting the upper and outer cheek
  • I notice some rounding of your lower eyelid as well as a lower lip position on the more laxed side of you face. Get more information on tightening options such as jowl and cheek lifting options such as Silhouette and other minimally invasive FaceLift suspension sutures.
  • Sculptra and ThermiTIGHT are another consideration for facial tightening.
  • Botox has no real place in enhancing your concerns.


I hope this is helpful. All the best!

Read more about similar topics:

Silhouette InstaLift

Cheek Lift

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at (410) 602-3322 or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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