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What Can Be Done About Premature Jowls and Sagging Lower Face? (photo)

I recently had a PS tell my lower face complaints are in a "gray zone"; my deformities are noticeable but not dramatic enough to merit a lower facelift. He also said I would likely be unhappy with face/neck liposuction because of the potential for more loose skin. He said possibly Ultherapy but that he was never impressed with the results. Are there any possibilities for me? Through surgical or non-surgical means? I'm willing to do more than one procedure if it means good results over time.

Doctor Answers (26)

A mini facelift can correct early jowling and neck laxity


Thank you for your question.  I do see early jowl formation, neck laxity, and sub-mental fat under your chin.

I do think a neck lift or mini lower facelift with defatting of the neck would achieve the result that you want.I do not believe that Ulthera we will give you the result that you want.

Laser assisted liposuction will remove neck fat and tight near skin but I do not believe it can safely improve the jowls.

Boston Plastic Surgeon
4.5 out of 5 stars 31 reviews

Facial rejuvenation



Yeah, I would avoid the Ulthera treatment.  I did perform about 60 of these with decent results but it's definitely on the subtle side and in your case not a useful venture.

I combination of jawline tightening and reduction of the heavy loose tissue beneath the chin and jaw coupled with some volume of the midface and cheeks would be helpful.

You may be familiar with the info attached but I'll include it just in case.

Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Jowls and extra neck skin


Whether or not your extra neck skin and jowls is worth undergoing a facelift (or any correction) is a decision for you to make.  From your pictures, you would benefit from a facelift and defatting of the neck.  Non-surgical means would offer some correction, but in my experience are not worth the money paid for multiple treatments.  An in-person consultation and a thorough discussion of the risks and benefits of surgery should help you determine which solution is right for you.

Jason J. Hall, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 3 reviews

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From the photographs, it appears that neck laxity and jowling are present.  The best non-surgical option is ulthera; however, multiple treatments (2 or more) would be necessary and still not produce equivalent results to a lower face / neck lift, whereby fat is removed and tissues tightened. Good luck!

Jeffrey B. Wise, MD, FACS
Wayne Facial Plastic Surgeon
5.0 out of 5 stars 51 reviews

Face lifts


You can tried Thermage fist as a non surgical option to thigh the skin the result is limited but is a non surgical procedure otherwise  you need a neck lift.

Alejandro J. Quiroz, MD, FACS
Mexico Plastic Surgeon
4.5 out of 5 stars 66 reviews

Sagging Lower Face & Jowls



Thank you for your question and for providing photos.  I agree with many of the other plastic surgeons that you would benefit from a neck and face lift.  Liposuction would worsen the loose skin, and I am not a fan of Ulthera.  I recommend scheduling a consultation with a board-certified plastic surgeon to determine what your options are.  I think your result has the potential to look fantastic and take 10 years off of your neck.

Best of luck!

Ashley Gordon, MD
Austin Plastic Surgeon
5.0 out of 5 stars 16 reviews

Early facelift options


Dear seekingPS,

  1. It sounds like you were seeing a knowledgeable and conservative plastic surgeon
  2. Liposuction would probably leave you with underwhelming results, loose skin, and possibly scarring
  3. I think a conservative necklift would look great where the excess fat and neck skin can be removed from hidden incisions...the jowl can be addressed through this approach as well

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Options for jowls


It's hard to say without an exam. My guess is that a little bit of micro-liposuction would improve the area without causing sagging. I am not a fan of Ulthera. A lift might help as well. I don't think lasers, peels or Fraxel will work. Sometimes fillers can camouflage  the jowl.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 24 reviews

Consider Ultherapy when too early for a facelift


Ultherapy has improved and we are seeing very nice results in patients who are noticing some slight laxity in the lower face but not enough to justify a facelift. This is typically patients in their 40's to early 50's. We sometimes combine it with a conservative amount of liposuction for enhanced results.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

Ready for a facelift?


Based on your photos, you would likely benefit from a facelift as the other surgeons on this site have also said.  A facelift, sometimes in combination with neck liposuction, is a good procedure to correct jowls and a neck contour.  I would suggest that you consult with a board certified plastic surgeon and discuss your concerns and expectations.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 8 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.