Jowls are actually caused by different things than double chin or loose neck skin. One of the things that we focus on in our practice is correctly diagnosing the underlying causes of any cosmetic concern, because that naturally leads us to choosing the right treatment for it.Jowls are caused by a complex aging process where the fat pads in the upper cheeks ("cheekbone" area) lose some normal volume (fat volume at first, but in advanced aging, we lose bone volume as well), causing skin to droop downwards and forward towards the mouth. Then, as aging continues, you'll see some fat start to herniate and fall down into the jowls, weighting them down and making the problem much worse as this weighs on the skin and stretches it (eventually it will be stretched out beyond repair and lose all of its elasticity). So depending upon where you are in that process, we would choose treatments to correct those causes. For example, it you have just begun to lose fat in the cheekbone area, then that can easily be corrected by restoring the volume with dermal fillers - typically with Voluma or Lyft. If there is fat in the jowl, we can dissolve it with Kybella injections and that may allow the skin to bounce back on its own, but if things are very advanced, we may need a surgical procedure to address things down to the muscle level.Double chin and neck sag are caused by different underlying changes. Fat in the neck can be due to weight, but it's also something many people are genetically predisposed to regardless of their weight. If it's just fat and the skin is still tight and firm, then we might do CoolSculpting or Laser Lipo. This can still yield good results for those with moderate loose skin, but the results are always best in those who have good skin quality (that's the case with all treatments, always - but skin loses quality and stretch as we age - it's just a fact of life). If there is significant loose skin, we might consider adding PrecisionTX to the lipo, which is a laser run underneath the skin to create a tightening effect. That's, in our experience, the best alternative to a necklift. You can achieve the same result using ThermiTight with lipo instead of the PrecisionTX (They both work by heating the skin precisely from below).In any case, I think your best bet will be to see a doctor who performs minimally invasive treatments and ask them what results you could expect to achieve - because that's what really matters. And ask them to explain what's going on below the skin's surface, and how that affects your treatment options - hopefully that will help you to pick the best treatment for you.
