How do remove jowls if you have no real fat tissue left in your face? (Photos)

I have a tissue disorder where my doc has been putting restylane every couple of months to help control it. It works in most areas of my face except my jowls. They seem to get worse and pools within the area of the lax skin. They've tried a fat transfer as well but due to the bad tissue, the fat is no good either. Just left lumps all through my face. I'm only 43 and I look older than my 65 year old mom b/c of this tissue problem. :(

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