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This is a sign of childhood that is observed until middle school age: But, if, due to the development of the correct position of the tongue on the palate, a person doesnt develope the adult type of swallowing (in which the maxillae move forward and upward and expand, forming a triangle of youth, and not a childs plate-moon) , then these cute childrens cheeks, losing their tone, then they simply turn into jowls: And thus, the transformation from the child type of face to the old age pyramid immediately occurs

Month 12: Bloodwork comprehensive panel including B12, MMA, homocysteine

The pharmacy can check whether the formulation changed, whether a different B12 source was used, or whether there might be a quality concern with that batch