Options for jowl area? (Photo)

Question

I’m a 33 y/o female, 120lbs 5’5 and unhappy with the loss of elasticity in my lower face, specifically mouth are/jowl area. I tried Ultherapy last year and it did not yield any results. Curious as to what my options are? Thank you.

Nima Shemirani, MD · Answer

Hi @ShanaeNicole28. I recommend Morpheus 8. Morpheus 8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting.

Best of luck,

Dr. Nima

Best of luck,

Dr. Nima

Jason Emer, MD · Answer

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Jonathan Kulbersh, MD · Answer

Hello, and thank you for your question. You can benefit from several lower face treatments. Chin augmentation and jaw contouring can be done using dermal fillers. Fillers enhance the lower face by restoring lost volume, contouring the jawline to create a sharper profile, balancing an asymmetrical jawline, strengthening the chin, and reducing the appearance of jowls.

You may also try Profound RF –a procedure that combines microneedling with RF energy to increase collagen and reduce facial wrinkles, as well as increase elastin to restore elasticity to the skin. To determine the best procedure(s) for you, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can do a proper evaluation, recommend and customize the best procedure plan, and ensure the best possible outcome.

Sam Speron, MD, FACS · Answer

Thank you for your question and picture! Your skin looks great! To address the lower aging of the face from your pictures, fillers in the chin and jawline will give you achieve a more snatched look.  Microneedling paired with PRP will promote collagen and smooth the area.  Laser genesis is another option to promote skin cell growth to address skin tone, appearance, and texture.  In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the neck and jowls.

Surgery is an option that you may not be quite ready for.   A mini facelift is a great option for many people. The recovery & downtime is very minimal.  There are never any guarantees of course with any procedure whether it is surgical or nonsurgical in nature.

I'd recommend not getting into the mindset of thinking the jowls or neck skin will be 100% gone with a mini facelift or neck lift as this might lead to disappointment. It is always best to consider that an area will be improved and discuss how much with your plastic surgeon.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of mini facelifts and neck lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps. If it does, please take a moment to up vote this answer on the “respond” button on the top right.  Have a great day.

Nelson Lee Novick, MD · Answer

I'm hardly surprised that you were disappointed with the results of Ultherapy. I have been cautioning regular readers of my answers for years about the use of fraxel lasers, RF devices and ultrasound machines since the use of these, faddish relatively expensive "bells and whistles" devices are backed far more by device manufacture supported marketing hype than hard science. Sorry. On the other hand, fillers, when performed by experienced injectors, have a proven track record of safety and efficacy for defining and straightening saggy jawlines and jowls What's more, the results are typically immediate and engender an on-the-spot "Wow!" reaction. Make sure to consult with a board certified cosmetic dermatologist and remember to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

Darryl J. Blinski, MD · Answer

I might offer a combination or mini FL/SMAS plication with HA fillers lifting. Best is virtual or in person consults. Fees in the $8,000 ranges.

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