Jowls Are Starting to Appear, What Do I Do?

I am in my late 30's. I noticed that the area on the side of mouth (smile lines) is sagging a little. Do you think I need a lower face lift or will something like restylane or juvederm work better?

Doctor Answers (6)

Fillers for early jowling

+5

There is a period of time between when the dreaded jowls start to show up and the time when surgery is warranted.

During that time, fillers such as Juvederm placed carefully along the jawline and in areas of hollowness in the face can go a long way.

Minimally invasive treatments such as fractionated laser, radiofrequency tightening procedures, chemical peels can all help.

Regular skin care and microdermabrasion treatments and a retinoid if appropriate are also helpful.

Patients should maintain optimal physical fitness to avoid excessive jowling that comes with frequent yo yo weight gain/loss patterns.

Patients should also avoid sun exposure and cigarette smoking, but I am nagging.

Minilifts should be carefully considered. As you can see from the posts, minilifts are not minimally invasive procedures that lower trained doctors do as an alternative to traditional facelift surgery. They are in fact real surgery. They leave real scars. They cause real pain. Minilifts performed on younger patients need to have an exceptional skill level to avoid detection. They should be performed by surgeons skilled in and experienced with full facelift surgery.

Even doing that facelift eventually doesn't mean the patient will no longer require maintenance; this will still be necessary for the patient who will not go down without fighting.

People who look absolutely fantastic for their age usually do many of the things above.


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 96 reviews

Jowls or Marionettes?

+4

As we age our skin becomes thinner and less elastic. Gravity adds a downward and, due to anatomy, a slightly medial or pull toward the center of the face. These are the reasons that we begin to see accentuation of the nasolabail folds and the start of the marionette line (the continuation of the nasolabial folds below the mouth) in our late thirties and early forties. In addition as the deep facial tissues descend the jowls appear.

This is a great time to attack the aging process head on. If you're not on Retin-A and a good skin care program you need to get started. To address the marionettes and the nasolabial folds fillers are great. Radiesse is great for the depression between the jowl and the chin as well as the marionettes and nasolabial folds at the nasal junction. Other fillers can be added as well.

Significant jowling will likely require surgery to both remove some fat and to resuspend the deep tissues.

So interview several surgeons and find the one that you connect with. Be sure your surgeon discusses all of these issues .

Christopher L. Hess, MD
Fairfax Plastic Surgeon
5.0 out of 5 stars 18 reviews

Jowls and treating the early signs of aging in the lower face

+1
Fillers such as Restylane or Juvederm can help treat the jowls in the lower face and restore facial volume. Thermage is also amazing at producing collagen especially in the lower face and jowls. I would recommend a combination of both treatments to rejuvenate the skin. Please consult a board certified dermatologist for the best cosmetic results. 

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 27 reviews

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Autologous fat for early jowling

+1

Early jowling can be nicely treated with filler augmentation.There are different options like Perlane, Radiesse or autologous fat.

Micro fat injections can improve significantly early jowling by augmenting the chin and jawline. This option can improve the results of a mini facelift and provides a very natural result.

Nicole Schrader, MD, FACS
Princeton Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Juvederm and Restylane fill lines, they don't take away jowls

+1

With the plethora of new technologies in medicine, it is very easy to get confused with what injectables can and cannot do.

Botox is a neurotoxin that paralyzes muscles. It is generally used by plastic surgeons to paralyze muscles in the face, and softens the wrinkles associated with overuse of these muscles.

Restylane and Juvederm, on the other hand, are synthetic fillers. They are used under the skin to fill natural lines, or to plump up areas. The most common areas of use are in the nasolabial folds or "smile lines" and in the lips.

What we call "jowls" are actually the natually aging process of gravity, where the cheek begins to descend in to the neck. I am sure there are people out there who believe that injecting something, or even performing liposuction alone, can remedy this problem, I personally believe that this is not the case.

A short scar or "mini" facelift can help lift the cheek back to its youthful position. I can understand that since you're only in your 30's, the idea of a facelift seems rather extreme. The truth is, with the advent of short scar and "mini" lifts, more and more people in their 40's are having these lifts done.

The one thing to mention about a mini lift is, sometimes a mini lift is so mini that it doesn't do anything. Make sure that you will have REAL results, as you are having REAL surgery.

Hope this helps!

Eric Chang, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 8 reviews

Jowls in the face of a young adult

+1

Early jowling in a person that is in theri 30's may easily be treated with facial fillers like Juvederm, Radiesse, or Restylane.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.