A national outlet asked me for a technical read on Katie Miller’s transformation, and I agreed with my colleague that the lower half of the face was where the change was. Here is the longer, candid version. It is an educational read from photographs, not a diagnosis. I have not treated her, and a photo is not a consultation.
The Before
In her earlier pictures, we can see that Katie has pretty full cheeks and fullness in the lower face, making her face very rounded, giving her a tired appearance. There’s also a lack of definition of the jawline.
The After
I think a combination of things has occurred since then. She does look younger and more refreshed. Her face is more triangulated, and her jawline is more defined.
What Could Explain It
I think she’s had a combination of botulinum toxin around the forehead, the glabella, and crow’s feet. I think she’s had some weight loss, probably aided by GLP-1, but the lower face change is rather significant.
I think this would only be achievable either with liposuction, with the aid of something like FaceTite for skin tightening and Morpheus8, both of which are radiofrequency treatments, and removal of the buccal fat pad. If she truly has had weight loss, she may be keeping the upper cheek fullness with fillers or biostimulators like Sculptra. Or if she actually had the liposuction and buccal fat removal, she may have had some fat injections to the cheek and zygomatic area. I think it would be a little bit too far-fetched to think that she’s had a lower face lift, although it’s not out of the question.
Why “She Had X” Is the Wrong Read
This is what I want colleagues and readers to take from it. From a photograph, the honest read is a hedged read. The lower-face change here could be a real procedure, a real GLP-1 weight loss, or a combination, and telling those apart from press photos is hard. The technical read is fair game. The flat “she had a buccal fat removal” headline is not, because the same look can be produced more than one way.
Why the Lower Face Did the Talking
The lower third integrates almost everything that happens above it. Volume that drops, skin that loosens, and weight that comes off all collect along the jawline and the lower cheek. So when a face moves from rounded and tired to triangulated and defined, the lower third is where I look first, because that is where the story almost always is. That is exactly why my colleague and I both landed on the lower half of the face.
The Credential Behind the Opinion
Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, American College of Surgeons Fellow, Mayo Clinic plastic surgery fellowship, Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, Editorial Board Member at Aesthetic Plastic Surgery, and Castle Connolly Top Doctor for thirteen consecutive years.
Ready to Talk?
If your own before-and-after is what is on your mind, the read on your face is the place to start.
For the patient-facing version of this read, see the companion post on agulloplasticsurgery.com. For the lower-face treatment menu, see the version on swplasticsurgery.com.
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