When a national outlet asked Dr. Frank Agullo for a technical read on Katie Miller’s transformation, he agreed with a colleague that the lower half of the face was where the change was. This is the longer version of that read, offered as an educational assessment from photographs rather than a diagnosis. Dr. Agullo has not treated her, and a photo is not a consultation.
The Before and the After
In her earlier pictures, Dr. Agullo says, 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. Since then, a combination of things has occurred. She does look younger and more refreshed. Her face is more triangulated, and her jawline is more defined.
What Could Explain the Change
In Dr. Agullo’s read, she’s likely had a combination of botulinum toxin around the forehead, the glabella, and crow’s feet. He thinks she’s had some weight loss, probably aided by GLP-1, but the lower face change is rather significant.
He believes 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. He thinks 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.
The Lower-Face Options at Southwest Plastic Surgery
| What Dr. Agullo Sees | The Option at the Practice |
|---|---|
| Botulinum toxin, upper face | Injectables at the Med Spa |
| Skin tightening | FaceTite and Morpheus8 radiofrequency |
| Lower-face fullness | Liposuction, buccal fat assessment |
| Upper cheek volume | Fillers, biostimulators, fat grafting |
| Real lifting if needed | Deep plane facelift |
Why the Lower Face Tells the Story
The lower third integrates almost everything happening 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 the work shows up, which is exactly why Dr. Agullo and his colleague both landed on the lower half of the face.
About Dr. Frank Agullo
Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, completed a plastic surgery fellowship at the Mayo Clinic, and sits on the Editorial Board of Aesthetic Plastic Surgery, the credential national outlets cited when they asked him to read this face. He is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine and has been named a Castle Connolly Top Doctor for thirteen consecutive years.
Ready to Talk?
If your own before-and-after is what is on your mind, bring the photos to Southwest Plastic Surgery. The team will read your lower face the same careful way and map a plan to the right options.
For the surgeon’s editorial take on reading public figures, see Dr. Agullo’s essay on drworldwide.com. For the patient-facing version, see the companion post on agulloplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful.
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