The development of facial jowls is one of the earliest signs of facial aging. As loose skin and fat falls over the side of the jaw, the once straight jawline of youth is gradually replaced by the saggy jowls of the older face. Time and gravity cause weakening of the attachments between the skin and the underlying muscle allowing a melted wax candle effect if you will on the side of the face.



Patients are really bothered by the development of jowling, particularly younger ages who see it as the reality that aging is occurring. There are numerous options to treat the jowls, both surgical and non-surgical, with varying degrees of effectiveness. The most effective methods, to no surprise, are surgical and include facelifts and liposuction. A facelift in its fullest extent is a jowl-neck lift. In its more limited form, it is primarily a jowl lift. It works by pulling skin and deeper tissues up and back, eliminating the jowls by pulling loose tissue above the jawline again. The loose jowl tissue is simply repositioned and not removed. More minor procedures that have recently gained popularity, which aims to do the same thing, are the Threadlifts or Featherlifts. In this simple procedure, barned sutures are passed deep into the cheek and facial tissue above the jowl area and cinched up from above. For very minor degress of jowling, this has some benefit but is not effective enough with large amounts of jowling and the long-term results with these procedures is suspect. Actually removing jowl fat can be done with liposuction, reducing their size. This can be done alone or in conjunction with some form of a facelift. When performed alone, liposuction of the jowls must be done very carefully and conservatively, lest you get irregularities that are apparent in the overlying skin. When done with a facelift, the lifting and tightening of the skin usually eliminates this concern.

Minimally-invasive treatment options are tightening of the skin by external heat-generating devices and LipoDissolve. neither approach treats both of the jowl issues, skin and fat, and therefore they are usually less effective than surgery. Some tightening of the skin can be caused by heating the underside of the chin through a series of treatments. Thermage and Skin Tyte devices approach the problem differently by heating up the udnerside of the skin so iy shrinks and contracts, causing it to tighten. The long-term results of this procedure appear to be short-lived and that is why I perform them in conjunction with other procedures rather than as a stand alone technique. LipoDissolve treats the jowls by fat-dissolving injections done as a series. The jowl is reduced in size by the fat-melting injections. In my experience, it is just as effective as liposuction, albeit a lot slower. When performing non-surgical jowl reduction, I like the combination of LipoDissolve and Skin Tyte. That combination seems be particularly effective as both components of the problem, skin and fat, are addressed. They are also great touch-up procedures to do after a facelift when a little rebound relaxation in the jowl area occurs.

Different surgical and non-surgical treatments exists for the jowls. The range of different facelift options create the best results that will last the longest and should always be chosen in the more severe cases of facial jowling. In more minor jowling, LipoDissolve and Skin Tyte work well if the patient can tolerate a slower speed of noticeable improvement.