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

Dear seekingPS,


It sounds like you were seeing a knowledgeable and conservative plastic surgeon

Liposuction would probably leave you with underwhelming results, loose skin, and possibly scarring

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

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!

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.

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.

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.

The aging phenomena demonstrated in the photograph are well handled by a facelift. Skin tightening technology does not work. Get another opinion.

Face/neck lift is the answer to excess neck skin and jowls. For 35 years I have told patients that they have a mirror and can decide when they are ready for surgery. Other minimal treatments are a waste of your money! See a very experienced facelift surgeon. 

If these problems bother you enough to spend money on them then don't waste your money on non surgical options.  It appears as if your skin is loose enough that it will require surgery to take care of. Talk with other plastic surgeions to get other opinions.

Good Luck,

Dr T

Thanks for the photos. You do have fairly mild jowl and neck laxity that is very common. Some of the laxity and heaviness of the skin could be improved with a facelift procedure. You would likely be a good candidate for a short incision technique that would minimize the length of the scar and its visibility.  I don't think you will see a meaningful improvement with non surgical treatments but you could try Ulthera or thermage and see if you have some success. Neither would preclude you having a surgical procedure in the future. The attached video shows Typical Age Related Changes of the Face. Best of luck!

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.