Jowls-Remove Jowls For A Young Looking Firm Jaw Line

Brooke R. Seckel, MD, FACS

Article by
Boston Plastic Surgeon

The Jowl, that puffy loose skin on the jaw line below the corner of the mouth is an early sign of facial aging. A smooth clean jaw line is an important key to a young looking face. With aging, fat atrophy causes facial volume loss and when combined with loss of skin elasticity, we begin to see excess skin along the jawline.

What Causes Jowls?

o Skin Laxity-As our skin ages it loses elasticity and the skin along the jaw line begins to sag.

o Loss of Facial Volume-As we age our facial fat atrophies, the face is less full, and the skin envelope becomes lax and sags.

o Repeated Mouth Movements-Smiling and facial expressions pull at the corner of the mouth and create a fold or line over which sagging facial skin can fall. Above the mouth this fold is called the nasal labial fold. Below the mouth the line is called the Marionette Line-also called the Pre Jowl Sulcus.

How to Remove Jowls.

Traditionally jowls have been removed by performing a facelift. More recently new non-surgical methods have also been developed:

o Facelift-The facelift is still the "gold standard' for jowl removal. A properly done facelift can create a beautiful youthful jaw line.

o Filler injections-Liquid Face Lift Soft tissue fillers such as Restalyn(TM), Juvederm(TM), Radiesse(TM), and Perlane(TM) are biodegradable semi -solid medical compounds that can be injected underneath facial lines to plump the skin. More recently, a technique called the liquid face lift is used to inject these soft tissue filers into areas of the face which have lost fat. By increasing the volume in these areas the sagging skin can be lifted.

o Fat Transfer- A more permanent filler is the use of your own body fat to inject into the pre jowl sulchus using a technique called Fat Transfer.

o Botox or Dysport- A  facial muscle called the Depressor Anguli Oris Muscle pulls the corner of the mouth downwards. This action deepens the Pre Jowl Sulchus or Marionette Line and accentuates the Jowl. Botox or Dysport can be used to weaken the Depressor Anguli Oris (DAO) and lessen the Pre Jowl Sulchus and thus the Jowl

o Laser Skin Tightening with New Laser Liposuction- New laser liposuction technology using 924nm and 924/975nm laser fibers, can be used to tighten neck skin and skin along the jaw line. The technique must be done by experienced Plastic Surgeons who know how to protect important nerves running along the jaw line near the mouth. However, early jowls have been successfully removed with expert surgeons using this technique.

o Other Skin Tightening Techniques-Many non-surgical skin tightening technologies are available. These include Thermage(TM), LuxIR Deep(TM), Titan(TM), and Refirme(TM) among others. All of these technologies tighten skin by heating the collagen in the deeper skin layers. When the collagen is heated to 66 degrees centigrade, the skin collagen contracts and the skin tightens. Beware, that tightening with these methods is at best 20-30%, thus they are most effective on younger patients with early and mild skin laxity and early sagging.

Do not wait until you need a facelift. Learn more about Fat Transfer, soft tissue fillers and the newer laser skin tightening treatments that you can have to keep a smooth jaw line.