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Effective and Long-lasting Procedure for Lifting Jowls?

asked 3 years ago by SanDiegoBarb in san diego CA
Latest answer by Larry S. Nichter, MD, MS
Question viewed 6,668 times
Tags: jowls, sagging, Virtual consultation

What's the best way to get rid of jowls that are beginning to appear from the corners of my mouth down to my chin? It's especially noticeable in my profile view. About a year ago, I had Restalyne treatments in the areas just below the corners of my mouth with only limited success. Is there any longer-lasting, more effective treatment specifically for "lifting" jowls? I'm 51 years old and have really good skin otherwise. I'm including two side by side pix after I was snorkeling in Aruba last spring, so I look really bad, but it pretty clearly shows the jowls issue.

29 answers to Effective and Long-lasting Procedure for Lifting Jowls?

+3

Vertical facelift is the best option to improve jowls

The best option for correcting the jowl is a Facelift and the best Facelift technique for the jowl is the vertical Facelift. This procedure requires an extended skin elevation to the corner of the mouth so that the full extent of the jowl can be seen. Then the excess fat can be directly excised and the sagging tissue can be lifted upward instead of backward ( like seen with the more typical SMAS lift or deep plane face lifts).
Jason B. Diamond, MD

Beverly Hills Facial Plastic Surgeon
+2

Long Lasting Facelifts

Effective restoration of the face which is done with a “Lift & Fill” facelift where the central facial and malar deep fat compartments are filled with your fat and then the deep layer SMAS is used as an anchor to lift the deep layers of the face, This facelift has longevity and allows for a natural, youthful result. The correction of the aging perioral area is more complicated. If there are deep folds around the lips (commissures) then the facelift will help with deep... more
Rod J. Rohrich, MD

Dallas Plastic Surgeon
+2

There is more than one way to skinny up a jowl

I do not think that facelift surgery is the only option for the correction of jowls. It is just one of the techniques that can be used. It is important to remember that jowls can be caused by multiple conditions such as gravity pulling the jowl tissue down, selective fat atrophy or loss of fat in the face which produces an indentation in front of the jowl making the appearance of the jowl worse as well. The techniques of filler injections around the jowls do not... more
Boris Volshteyn, MD, MS

Reno Plastic Surgeon
+2

The best way to address kowls

Addressing the relaxation of the SMAS (Muscle) as well as the fatty tissue relaxation in the jowl area will give you the longest lasting results.
Vivian Hernandez, MD

Boca Raton Facial Plastic Surgeon
+2

Camouflage vs corrective interventions

There are many options and there is no one right answer. It may depend on your "appetite" for correction. As you have had restylane, you are now familar with what we would call a camouflage procedure. These are interventions that compensate or mask the signs of aging without necessarily correcting the problem. The jowls are a difficult area that are effected by the size and shape of the mandible (jaw bone), fatty deposits of the skin and buccal fat pad, skin and muscle laxity... more
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Effective Procedure for Jowls

Your photos indicate that a facelift procedure will give you the most long lasting results. I would recommend a short scar facelift technique that utilizes a vertical lift (anti-gravity) and also tightens the underlying supportive tissue called the SMAS.
Larry S. Nichter, MD, MS

Orange County Plastic Surgeon
+1

Jowl Recommendations

The temporary solutions include a variety of injectables. Restylane is the easiest product to inject, but is not the product of choice because it is so short lasting. Perlane and Radiesse are both butter, and likely I’d recommend Radiesse. Of course some type of midfacelift or full facelift is the best approache with the longest lasting result.
Jeffrey Epstein MD, FACS

Miami Facial Plastic Surgeon
+1

How to Make Facial Jowls Better

Facial Jowls generally result from the descent of facial fat with age, causing the accumulation of tissue that makes the jawline appear less defined.  Soft tissue fillers provide a "back-door" treatment by filling areas around the jowls, making the jowls seem less prominent.  The best long lasting and most controlled treatment of jowls is a facelift using the SMAS layer to re-suspend facial fat to its youthful position at the cheekbones.  Looking at your... more
Daniel Shapiro, MD

Scottsdale Plastic Surgeon

shapiroplasticsurgery.com

+1

Best Fix for Jowl Area

It appears from your pictures that you may be a good candidate for a lower face and neck lift.  I would recommend seeing a couple of different Plastic Surgeons.  Always make sure to check their credentials.  A big part of the consultation process is reviewing their before and after pictures.  This will give you better perspective on the capability of his/her work.
Miguel Delgado, Jr., MD

San Francisco Plastic Surgeon

www.dr-delgado.com

+1

Recommend lift

Based on your pictures, I would recommend a facial SMAS resuspension procedure with liposuction.  I feel that Jowls represent laxity of facial musculature and connective tissue.  The skin merely follows the underlying muscle and connective tissue.  I would therefore recommend the resuspension procedure i.e. lift.  I would also like some detailed photographs of your oblique and profile views.  In some patients, loss of facial voilume can also create jowling.... more
Raghu Athre, MD

Houston Facial Plastic Surgeon

www.athresurgical.com

+1

Mouth folds Lip Folds Best treatment

I would agree with the other doctors here and that a lift would be the best thing initially.  Although using fillers along the way may also be beneficial if the desire is to minimize the appearance of these folds. If you have not achieved success with the first injections, it could be that not enough product was used to "make a difference."  If however adequate volume was used, then I would consider a Lift.
Jon E. Mendelsohn, MD

Cincinnati Facial Plastic Surgeon

www.351face.com

+1

Lifting Jowls

From your photographs, I'd suggest a combination of techniques including selective liposuction, face- and necklift, as well some filler (Juvederm Ultra Plus will probably last longer than the Restylane).
Paul C. Zwiebel, MD

Denver Plastic Surgeon
+1

Jowl Correction

Jowls are comprised of descended skin, fat, and muscle.  Correction of the jowls is based on the underlying cause of the jowl, and can be a combination of sculpting, addition, and lifting.   see video
Anil R. Shah, MD

Chicago Facial Plastic Surgeon
+1

Effective and Long Lasting Way to Address Jowls

The gold standard in addressing jowls, the jawline, and the neck is a SMAS imbrication Facelift.  What is really most important is who performs the procedure. San Diego (and indeed all of Southern California) has a great deal of well trained Facial Plastic Surgeons and Plastic Surgeons.  I recommend that you ask around and see a few Surgeons; make your decision based on your comfort level with the Surgeon, the office, and on the results that you are shown.
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

www.drprendiville.com

+1

Prominent Jowling

I would recommend neck and jawline liposuction, buccal fat pad excision, and a short scar facelift with MACS lift technique or Lateral SMASectomy.   This procedure results in a 7-10 day downtime, requires use of a neck/chin strap garment x 2 weeks.  It can offer substantial correction to your concerning jowls, yet provide a natural elegant result.   
Paul S. Gill, MD

Houston Plastic Surgeon
+1

Surgery will give a much better result for lifting jowls than fillers

Looking at the photos you supplied leads me to recommend you undergo a facelift.  Jowling is the result whenever there is descent of the lower facial tissues due to gravity, aging, loss of skin elasticity etc...Jowls go hand in hand with the lines you describe from the corners of your mouth; these are referred to as marionette lines. A filler should be thought of as a form camouflage for various lines and folds. Fillers do not provide 'lift' in the same way... more
Lawrence Tong, MD

Toronto Plastic Surgeon
+1

Proper way to correct jowls

As with any procedure, the first thing a surgeon needs to do is make a correct diagnosis.  The jowls usually are caused by normal aging of the face, but in some individuals there is an additional component that causes jowls, and that is buccal fat.  If that is not addressed than the results of a face lift will be sub-optimal, of course removing buccal fat in a wrong patient will also cause sub-optimal result.  As for the type of face lift,  the surgeon needs to address... more
Boris M. Ackerman, MD

Newport Beach Plastic Surgeon
+1

Fillers are not the answer for marionette lines and jowls

While this is unlikely what you want to hear, you are an outstanding candidate for a facelift. A common misconception is that the marionette lines that you discuss in your question are best treated with a filler like Restylane. These depressions are not caused by a loss of tissue in this region. They should not be treated by replacing volume into the shadow.  These lines are created as facial volume above and lateral to this area droops. Because there are ligaments that hold the... more
Adam David Lowenstein, MD

Santa Barbara Plastic Surgeon
+1

Lifting jowls

Thanks for the photos. My choice is a SMAS facelift for your issues, maybe even a deep plane technique. Seek at least 3 opinions from boarded plastic surgeons in your area. From MIAMI DR. B
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

A facelift is great for correcting sagging jowls

It appears from your photo that you're a great candidate for a facelift.  This will allow access to the skin and muscles at the jowl areas and allow a good "pull" to make your jowls less noticeable.  The procedure can also correct any hanging skin of the neck as well as lifting the cheeks.  The incisions are kept right in front and behind the ear, so they are not very noticeable.  Also, the recovery takes about 1-2 weeks with pain being well controlled with... more
Jeffrey E. Schreiber, MD

Baltimore Plastic Surgeon
+1

Treatment of jowls

The jowls are at the lowest part of the face and so they will become prominent as the tissues above begin to stretch and sag.  Although injectables are useful to camouflage early problems, ultimately you will need a facelift.  With a facelift procedure the underlying muscle and fat is pulled back to where it belongs and the excess skin is removed.  You will have a beautiful jaw line and no more jowls!
Randy J. Buckspan, MD

Austin Plastic Surgeon
+1

Jawline jowls are best treated with a facelift

The jowls are created by sagging and redundancy of the SMAS which is the supportive musculature of the face swagging like curtain call. The best and longest lasting way to treat this is with a hidden short incision placed inside the ear canal and wrapping around the ear lobe so it is hidden, lifting the skin and tightening the SMAS muscle by lifting it and removing the excess. Mini face lift procedures lift the skin less and require less muscle work. The amount required is dependent upon... more
Andrew Jacono, MD

New York Facial Plastic Surgeon
+1

Lower facelift will give lasting results

The most effective and durable treatment for your jowling is a lower facelift. With an extended SMAS plasty technique, one will see nice improvement of the cervicofacial contour and look rejuvenated that will last many years (in our experience 10 years). There are less involved options such as using a filler to disguise the jowling or laser resurfacing in an effort to tighten the skin somewhat, but these don't last as long and can't achieve as significant result as a facelift. more
Corey S. Maas, MD

San Francisco Facial Plastic Surgeon
+1

Long lasting jowl treatment

The only long lasting jowl treatment I  know of is a facelift.  Sometimes you can camouflage it with a filler. It looks like on your photos that you have some fat under the chin which could benefit from suctioning as well.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Effective and long-lasting procedure for lifting jowls?

 Not a problem - just some time in the OR. Take a look at my web site link.  You'll see many patients with "jowls" that have a good long term follow up improvement.
Michael Kulick, MD

San Francisco Plastic Surgeon
+1

Non surgical approach could be fillers to Pre jowl sulcus and Botox to Depressor anguli Oris Muscle

Surgical approach would include  a face and neck lift with release of the depressor anguli oris muscle and mandibular ligament.  there is a need for sculpting the fatty tissue at the jowl area and adding fat to the depressions on the sides of the chin to make a smooth line at the jaw line.
Amir Moradi, MD

San Diego Facial Plastic Surgeon
+1

Longer term correction of jowls

Tissue fillers such as Restylane can be beneficial but you have to understand that they are rather "temporary" procedures. The fillers do help add volume to lines, and areas with lack of volume. They are minimally invasive with little or no "down time" and many people find this attractive. Typically, the fillers last about 6-9 months. The filler can be repeated. You seem to be asking about a longer lasting solution. Looking at your photo and based on your age you are... more
James H. Schmidt, MD

Sarasota Plastic Surgeon
+1

Jawline Jowls

The answer depends on the commitment you want to make. As you have seen, lesser procedures such as fillers. skin resurfacing, mini-lifts, and imlants will minimally improve the appearance. There is nothing wrong with this approach, but the ultimate result would be achieved with a facelift including liposuction and a pre-jowl implant. It would be benificial to loose weight prior to any procedure. I strongly suggest you do this and then re-evaluate your alternatives.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+1

Fillers and facelift surgery are your best choices

Based on your photos, it might appear that another round of fillers could be of benefit. A well performed cheek and neck lift (facelift) would also be very beneficial in eliminating the jowls, smoothing the jawline and removing the fat in your neck. All of these would produce an very nice benefit to your face.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

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