In the quest for more sculpted cheek bones or a well-defined chin, contouring with makeup can go a long way. That being said, if you're seeking more dramatic—and/or long-lasting—results, there are a number of minimally-invasive cosmetic procedures that can go a long way towards subtly changing and re-shaping the contours of your face. While they're most often associated with smoothing out wrinkles, injectable neurotoxins and fillers offer a quick and easy solution, but they're not the only choices available. Ahead, Manish Shah, M.D., a board-certified plastic surgeon in Denver, CO, Tanya Judge, M.D., a double board-certified plastic surgeon in San Francisco, and Dr. Y. Claire Chang, a board-certified cosmetic dermatologist at Union Square Laser Dermatology in New York City, weigh in on six of the most effective facial contouring treatments.
Arguably the most popular option for non-invasive facial contouring, there's a plethora of different fillers on the market, and no shortage of different ways to use them. "By injecting them into the wrinkles, folds, and hollows of the face, you can create a smoother, fuller, and more contoured facial shape," says Shah. More specifically, "We can add filler to cheekbones for a lifted appearance, elongate the chin to create a more oval- or heart-shaped face, non-invasively define the jawline, make the nose bridge higher, invert downturned lips, or correct any facial asymmetries," adds Chang.
There are hyaluronic acid fillers (common brands include Juvederm, Restylane and Belotero), which, simply put, work by injecting hyaluronic acid gel into the areas of volume loss. Of these, there are both thicker and thinner versions; they vary based on how the hyaluronic acid molecules are linked together. Their differing consistencies make them better suited for contouring different spots on the face. "Thick fillers go into areas where you need structural support such as the temple area, cheekbones, jawline, and chin. Thinner fillers are used in the lips, nasolabial folds that run from nose to mouth, and marionette lines that happen around your chin," explains Judge. Hyaluronic acid fillers can even be used for what's known as a liquid rhinoplasty to alter the shape of the nose, she adds.
Other fillers, such as Radiesse and Sculptra, work by stimulating the production of new collagen over time, and also yield successful results when it comes to volumizing the face, says Shah. Pros of fillers include their versatility and ability to be used all over the face, as well as the fact that the procedure is fairly painless and cost effective when compared to other, more invasive options. The side effects and downtime are also fairly minimal: "There's a risk of redness, bruising, swelling, and tenderness with filler injections, which typically resolves over a course of one to two weeks," says Chang. The cons? Results aren't permanent. Fillers usually last anywhere from three months to five years, depending on the exact filler used and where in the face it's injected, says Shah.
The fan-favorite wrinkle fighter can also be used to narrow your jawline. "Injecting Botox into the masseter muscle—the big chewing muscle in your jaw—causes it to atrophy over time and can change a square-shaped jaw into more of a heart-shaped jaw," says Shah. (It's often injected in this area for medical reasons, as a way to address TMJ, but can also be used solely for cosmetic reasons.) Shah adds that Botox can also be injected into the chin muscle to reduce wrinkling and elongate it from a frontal view. As with fillers, results aren't permanent; plan on repeating the injections approximately every six months, says Chang. However, with repeated use, the muscle activity stays suppressed so the muscle shrinks long-term, allowing for dramatic jawline narrowing, explains Shah. The downtime is minimal, and, while more units are generally needed than for wrinkle-smoothing facial injections, it's still fairly affordable.
Consider this if the area you're trying to target is under/around your chin. The injectable contains a substance known as deoxycholic acid that melts fat cells, and is FDA-approved to use under the chin, a good option for patients who want to get contour the area, says Shah. While both doctors we spoke with agree that liposuction will yield more dramatic contouring results in this area, Kybella is permanent and a good alternative for those who don't want to undergo surgery. "In clinical trials, more than 80% of people reported improvement and satisfaction with the results of Kybella treatment," notes Chang. Still, the injections are painful, so expect a significant amount of swelling for about one to two weeks afterward, during which you'll likely have to wear a head brace and be in some discomfort, notes Judge. She also adds that multiple rounds of treatment are usually needed for the best results.
This is another contouring treatment that can be used to treat a double chin and define the lower face and neck, says Chang. Also known as cryolipolysis, this works by selectively freezing and destroying fat cells, and, on average, yields about a 20% fat reduction in the treated area, she adds. The treatment time for the chin area is usually about 45 minutes; possible side effects include temporary redness, swelling, numbness, and tingling. While the results are permanent, keep in mind that they're by no means instantaneous: "It may take up to four months after a single treatment to see the final results," says Chang.
Treatments such as Thermage utilize radio frequency, which is where electrical energy generates heat that triggers skin-tightening, and, at higher temperatures, fat melting as well, says Shah. How? "Heat-related damage to the skin in a controlled fashion results in the creation of new collagen. This in turn results in plumper and tighter skin," he explains. There are a variety of different ways to administer the radio frequency energy, both non-invasive (via topical paddles applied to the skin) and invasive, via micro-needling or small tubes under the skin, says Shah. The former comes with minimal downtime, the latter with one to seven days of recovery needed, depending on the particular modality. Either way, you won't see the effects for at least six months and they're not permanent. "The skin will tighten initially, but then loosen up again with time. Anyone who gets radio frequency will generally need multiple rounds over their lifetime," points out Judge. The pros: The risks are usually minimal and the treatment well-tolerated, says Shah, and it can be especially beneficial for re-shaping and tightening the lower part of the face and neck.
"As plastic surgeons, we have all of these synthetic materials at our disposal, but we also have the natural stuff," says Judge. "Rather than using fillers, you can take a patient's own fat and place it into the same areas as you would fillers." She adds that fat is especially good to use to volumize cheeks, fill in hollows under the tear trough, and define the jawline. This is the most invasive option on the list, as the fat will first have to be retrieved from elsewhere on your body through liposuction before it can be injected into the face. But it's generally very effective and essentially permanent, says Judge: "50 to 80 percent of the fat cells that you transfer from one part of the body to the other will survive, and will behave like your own cells for life."