What is the best approach to eliminate fat pockets (jowls) and define my jawline?

you need a face, necklift and eye surgery (upper and lower blepharoplasty), you also will need in office fillers, lasers and at home peels and skincare (see link) for now. your best bet is a full make over and then start maintenance treatments after.

if you want a dramatic change necklift/facelift, Implants and fillers will give you that. noninvasive will improve the area and facetite, threads, morpheus, and fillers can be used.  start at home dermarolling to tighten you skin, see emeragecismetics.com where we do free skincare consults daily and recommend emerageskin roller with anteageMD ampules daily (see dermarolling package).

With significant neck sagging you would need a neck/face lift with muscle tightening (platysmaplasty). at the same time lasers (fraxel,  co2 or erbium( or microneedling RF (fractora, intensif) can be . performed to improve the crepe skin or wrinkles.  You need a formal consultation, as the neck can be treated with a combination approach:
1. micro needling and lasers for texture
2. botox, disport or xeomin to help platysmal bands
3. intensif or fractora RF microneedling for crepe skin and lifting
4. fillers like belotero, restylane silk, juvederm volbella to improve lines and folds
5. neck/face lifting if sagging is prominent or early starting +/- platysmaplasty (muscle tightening)
6. J plasma/Renuvion, thermiRF, inmode facetite for internal tightening
7. ultherapy and thermage for external tightening
8. regular Venus legacy, exilis ultra, or inmode forma treatments with facials to maintain tightness
9. PDO novathreads or silhouette instalift cone threads for lifting and long-term collagen production
see an expert for a full evaluation and treatment plan based on your individual situation and goals.
Best, Dr. Emer

Hi @Anon352358! I recommend Morpheus 8. Morpheus8 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.

In looking at your face I believe the whole face should be evaluated. It is difficult to tell from your photos but it appears as though you should consider addressing your eyes as well as your face and neck. Fat removal from the face has to be done very carefully because we tend to lose volume in the face as we age. Repositioning the fat is generally a better option. I think you would be better served with a face and neck lift and possibly a chin implant or fat grafting to the chin. It is difficult to tell from your photos as to whether buccal fat pad removal would be beneficial as well. I would not recommend Kybella to your jowls. Please see a board certified plastic surgeon experienced in facial rejuvenation and thank you for your question.

The photographs demonstrate a recessive chin profile, jowls, fat deposits in the neck along with inelastic skin in the face and neck itself. Consider a comprehensive lower face and neck lift which can accomplish tightening loose facial and next skin, tightening loose facial and neck muscles, lifting the jowls, and removing the fatty deposits in the neck along with the platysma plasty to significantly improve the jawline. Also consider placement of a small chin implant to augment the chin forward for better facial balance and proportions from the side profile, and also build out the pre-jowl sulcus present in front of the jowls themselves.