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Cause for flat forehead, square maculine face.

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I am a 36 year old female and I have a few issues going one. First my face has started to look masculine in my opinion. I have always had a strong face, but it looked much more soft in my youth. Also, the shape of my face has changed. I had a nice heart shaped face, now it looks rather square/round. I have fat in the jowl area, that I didn't have before.I don't have drooping or sagging skin however. I have gained some weight, since I was younger as well. My forehead has also gotten pretty flat/hollow. My nose has also started to look longer and bigger, the tip looks like it's falling a little. I think all these changed are contributing to my masculine look. I asked a woman where the bathroom was, and she told me where the men's room was. It was very hurtful to hear, but at least I know it's not in my head.I want to know if it's a volume issue, or do I need something more drastic like a face lift etc. I just want to look softer like I did, when I was younger. I have attached a few pictures. The one with short hair and I look really thin, is when I was younger. The others are of me now. Please advise!

Category: Cosmetic and Plastic Surgeon

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Category: General Surgeon
 21 Doctors Online

Thanks for your query at
Yes, your face looks different from that in your youth. It is now coarser and there are signs of aging. I do not know whether you had a lip augmentation or not but your lips look rather heavy in your pictures, may I suggest you go ahead with a lip reduction first of all?
I would not suggest a conventional facelift, however, a minilift might be advocated. Much more important, however, is the need for fat grafts to multiple areas of the face. Targeted fat grafts to areas of hollowness combined with minilift can go a long way to improving your looks. You might also want to alter your hairstyle as in your youth because your new hairstyle actually makes your forehead look much more prominent.
Dr. Souvik Adhikari, MBBS, MS, MCh (Plastic Surgery)
Consultant Aesthetic, Plastic & Reconstructive Surgeon.?

Patient replied :

Thank you for the response. I have done nothing to my lips. Can lips become bigger as you age? I would assume it's probably the volume loss to certain areas, that make my lips appear bigger. Why would you suggest lip reduction? Also, which areas of my face do you suggest having the fat grafting applied to? What about sculptra? Is that as good as fat grafting? I think I will try the fat grafting first and hold off on a min face lift, because my face isn't drooping or sagging.

Yes, there are no problems in having your lips reduced, they are appearing so prominent I would like you to give it a thought.
Regarding fat grafting, get it done over the forehead and the malar areas (largest volume would be required here). Combined with a minilift this should do the job.

Dr. Souvik Adhikari
Category: General Surgeon
MCh (Plastic & Reconstructive Surgery): Institute of Post Graduate Medical Education & Research, Kolkata.
MS (General Surgery): Medical College, Calcutta
MBBS: Medical College, Calcutta.
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