Hi, I have performed many facial shaping procedures, over the past 30 years, using liposuction, dermal fillers and/or facial implants (cheek, chin). Jowls are sagging facial tissues that occur between the corner of the mouth and extend to the jaw line. Liposuction can be done in the jowls when there is excess fat along with the sagging facial tissues. This must be done with care and by an experienced surgeon as a vein, artery and the only motor nerve that operates the lower lip muscle travels within or immediate adjacent to the jowl tissue. Liposuction alone will not reverse or elimate the presence of jowls which are the primary indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-op I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. If there is excess fat, skin or muscle laxity (platysmas banding) this can be addressed with liposuction of the neck, skin removal through an incision under the chin or a formal Neck Lift. Think of the jaw line as a natural divider between the face (where the cheeks and jowls are) and the neck. Each area can be addressed separately or together depending on what needs to be accomplished. Often when there is evidence of a "double chin", the chin itself is weak. Non smiling photos of your face from the front and side would help in the evaluation. I have performed many Chin Augmentations using chin implants for over 30 years. A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective. I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone. In my opinion, your are a good candidate for chin implant surgery.Hope this helps.
