Q.

I was looking at some pictures of myself taken a few years ago, and I noticed that my face shape is more square now than it used to be.  I liked my old shape better, and I wonder if there’s some way to restore my face shape.

A:

Face shape is the result of our bone structure and also the soft tissues such as muscle and fat that lie beneath our skin surface.  While much of this is genetically determined, there are other factors that influence face shape.  In our youth, our faces tend to be more V-shaped–wider across the cheeks than across the jaw.  With age, our face shape tends to become more square as our natural fullness shifts from the upper to the lower part of the face.  Another very common cause of squaring of the lower face at any age is enlargement of the jaw muscle caused by clenching or grinding the teeth.

There are things that can be done to improve the balance between the upper and lower face.  Neuromodulator injections (such as Daxxify or Botox) are often used to reduce a bulky jaw muscle, resulting in a slimmer and less square jawline.  Often these patients also experience relief of jaw pain or headaches caused by clenching or grinding their teeth.  For age-related changes we use procedures that lift or tighten the skin, such as Sofwave and dermal fillers, to rebalance facial proportions.