I am currently 43. I had standard cheekbone reduction at 41 and mandibular angle shaving at 42. Despite being middle-aged, I wanted to see my face without cheekbones before I died, so I went ahead while accepting the possibility of cheek sagging. The lateral cheekbones / posterior cheekbones were reduced a lot. The effect on the 45-degree cheekbones feels somewhat minimal. I had asymmetry before too, but it was not improved by facial contouring. Rather, it seems to have become more noticeable. The sensation in one cheekbone still has not fully returned. That cheekbone area feels stiff and sore. For my jaw, I had a normal length and a subtle protruding chin, so I proceeded with shaving without osteotomy. I still have a slight tight pulling sensation toward the corners of my mouth, but there are no other problems. There is no sagging in the jaw, and maybe because they reduced the 45-degree cheekbone area less, or because I naturally have very little facial fat, I do not have sagging to the extent that I need lifting.
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