Dr Doft believes it is partly a natural ebb – “the aesthetic is changing”. (Just look at the generational gap over feathered trim and side-parted hair.) And it’s partly a rethinking of what’s youthful and, by extension, desirable for many patients. “That fleshier look is associated with youth—I mean, when you look at kids, they have full cheeks,” says Dr. Doff. But he also believes that the more we see sunken faces, the more we’re forced to confront aging—and it’s no coincidence that this self-reflection comes after so much GLP-1-induced weight loss. “The Ozebian face is a really hollow face—we know it looks drawn, it looks sad, it looks sick, and so we try to combat that,” says Dr. “Could this be our natural reaction, the repulsion?”
Instead of removing fat from the cheeks (liposuction) or injecting filler to create more sculpted cheekbones, more and more patients are putting fat in their faces. It can be used to fill in areas that lose fat with age, such as the temples, tear lines and cheeks. “Many of my patients love fat grafting. When I do liposuction, I often reposition the fat on the face—or chest—to increase cleavage,” says Dr. Doft. Facial fat grafting can be done as an adjunct to liposuction (when the fat is removed anyway) or as a stand-alone procedure (a small amount of fat is taken, through the lipoid, from areas such as the thighs or abdomen). The fat is injected into the face, where only 50 to 75 percent of it lasts, but what sticks is permanent—it adheres to surrounding tissues and forms a new blood supply.
“Personally, I really like fat, because it’s natural, it’s well tolerated. The downside is that it’s permanent – the upside is that it’s permanent,” he says Mark MoffidtMD, FACS, Board Certified Facial Plastic Surgeon in San Diego and Beverly Hills and Clinical Assistant Professor of Plastic Surgery at Johns Hopkins School of Medicine. For many people, that’s definitely a plus—”the concept of being maintenance-free is very appealing,” says Dr. Williams. “I think for Botox, people are kind of tolerant of having to come back again and again, but I don’t think [they do] as for filling”.
However, it is important to recognize that, with its permanent nature, fat grafting is not the only filler alternative for every patient. Once it’s in your body, it does what fat does: “If you put fat on someone’s lips and they end up gaining 30 or 40 pounds, their lips will get bulky,” says Dr. Moffidt. “All in all, then, I think we should tread carefully.”
Fillers will give way to scalpels along the jaw line.
You may have already heard of meowing, but for the uninitiated: It’s a new selfie trick—like pinching your cheeks for a quick flush, but it’s for your jaw. You put the top of your tongue at the top of your mouth and swallow, and you’re supposed to have a more defined jaw line. The jury’s out on whether it works, but one thing is clear — there’s “too much focus on the jaw,” says Dr. Doft. Why? Maybe—just maybe—we’ve become hypersensitive to criticizing our soft jaws. (For the record, anatomically speaking, this is a completely normal and expected change that occurs with age.) There are so many energy devices that promise to tighten the area and injections that want to “lift” it with fillers, that the jaws and jaws are more in the conversation than ever. However, many of these devices do not give the dramatic results that patients hope for, and trying to correct curves with fillers can require so much filler material that it cannot be seen. “People get frustrated with non-invasive things like Thermage or Ultherapy,” says Dr. Doft. “And they find that filler is expensive, it’s bulky, and there’s a huge fear now that fillers last too long [in your skin] and not leave [after they’ve been injected]and disfiguring your skin forever.” It has many people wondering if they want to continue the course with filler. “A lot of people say surgery is going to be their ultimate end goal, so why am I spending all this other money?” says Dr. Doff. And that leads us to more patients asking about facelifts to tighten their jaws. Many of them are relatively young – in their mid-40s and early 50s.
