I'm unhappy with my hanging cheeks, jowls and jawline. What options do I have to correct these areas? (Photo)

What is the least invasive way to improve the look of my lower face. I hate how the cheeks fold down and forward creating the unsightly crease. My jaw line is in need of fixing too. The saggy jowly bits are so aging! I have had rhinoplasty with chin and cheek implants to lift the cheeks and I have also had radiesse injections to lift the cheeks up. I want a permanent solution so I can get on with my life feeling pretty.

Doctor Answers 13

Face/ neck lift and chin implant candidate

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 The photographs demonstrate normal changes of aging with jowls, loose facial and neck skin, and fatty deposits of the neck along with a weak and recessive chin profile which exacerbates the laxity of the tissues in the neck. A lower face and neck lift and accomplished tightening the jowls, removing the fatty deposits in the neck and rejuvenating the jawline. Consider a chin implant to bring the chin forward for better structural support of the soft tissues in the neck. For many examples of both procedures, placing a link and the video below

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 155 reviews

Facelift for hanging cheeks, jowls and jawline

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From your photos you do have jowling, deep marionette lines and ptosis (drooping) of the lower face. You would benefit from a lower facelift which will correct your problem areas. This is a long term solution. Please consult with an experienced facial plastic surgeon and don't fall for any of the many "quick fix" procedures that being advertised. If you do your homework, you will find the results you desire. Best of luck.

James Shire, MD
Chattanooga Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Unhappy with hanging cheeks, jowls and jawline

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For a definitive solution to heavy jowling your options are limited to surgery. Given that your chief concern is your jawline and cheeks, and that your skin appears to have retained good elasticity, my recommendation is for a mini-facelift or cheeklift. 

Best wishes!  Harry V. Wright MD, Sarasota, Florida

Harry V. Wright, MD
Sarasota Facial Plastic Surgeon

Sagging Face -- Fillers/sculptra, Thermi, Thermage/Ultherapy/Venus Legacy, Viva Resurfacing; Neck/Face Lift

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There are a lot of options.  The most invasive being a neck/face lift with filler or fat sculpting.  Noninvasive options such as ThermiRF, Thermage, Ultherapy and fillers can be used as well.  Please see an expert for a consultation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 204 reviews

Lower face and jowls

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  Unfortunately there is no non-surgical way to correct your problems that will get you a result you will be satisfied with.
 If you accept this fact and agree you need a facelift; the question then becomes how can I do this as easy and safe as possible and still get a great result. 
 My suggestion is look into having a local anesthesia facelift with some simple oral sedation. I have been doing all my facelifts this way for the past 10 years. It removes nearly all the risk of the surgery. It decreases the amount of surgical bleeding remarkably. It lessens the post-operative swelling and black and blue of the recovery period. You are up and around very comfortable in a day or two and the degree of surgery and result is just the same as what I did for 20 years with general anesthesia.
  So the main reason to be anxious about a facelift..".the anesthesia process"...is removed from the equation.
The jowls, neck, and naso-labial line will all be much more youthful looking and appear totally natural after a well-done facelift. The results should also last a good ten years.
  Lasers, fillers, threads, suspension, cool-sculpting, Ultherapy will not get you anywhere near the degree of result as a good standard facelift will......and since I can do it very comfortably and painlessly with oral sedation and local anesthesia...It it the best way to go.


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Hi consider a mini-facelift under local anesthesia with mild sedation. This will correct your jowling with minimal swelling, bruising and downtime.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 283 reviews

Best Non invasive options for face and neck lift

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The most advanced treatment in my opinion would be the Profound Microneedle Radiofrequency device by Syeron Candela.  By no means are the results mind blowing, but it is more effective than all other non invasive devices.  Fat grafting is not a good solution for you.  Fillers will not give you the amount of change or duration of change you're looking for. 

The best option by far, otherwise, would be to perform a modified extended deep plane lift in the face and neck.  This is the most substantial, natural and long-lasting change you will see of any lift I have seen.  The results are very very natural and the before and afters are quite impressive.  The benefit is that you can avoid unpredictable fat grafting and not worry about other procedures.  The AuraLyft is a procedure that improves the area around the lateral eye and brow all the way down to the collar bones.  This can be performed using only local anesthesia.  

Ben Talei, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 50 reviews

I'm unhappy with my hanging cheeks, jowls and jawline. What options do I have to correct these areas?

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In our presented case with the posted photos, which were nicely done, I would recommend fr the least invasive options: A Silhouette Insta Lift mid face suspension sutures, 4 syringes of Volume to malaria areas, Juvederm to jugal groves. or a Liquid FaeLft with Silhouette InstaLift.. Fee $8,000.
In reality you would benefit from a Face/Neck SMAS Lift. 

Midface sagging

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fatarse, Making recommendations based on Internet photos is always difficult and at best is simply a judgement based on too little information. Having written that I would expect that I would be doing a deep plane minituck. Find someone who knows how to lift the midface; not fill it up with fat injections. I also think that your chin implant may be too small but that is just a guess. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 54 reviews

Unhappy with my hanging cheeks, jowls and jawline.

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  Hi, I have performed many facelifts over the past 30 years.  From the attached photos, the cheeks are flat anteriorly (in the front), there is excess facial and neck fat along with excess facial skin evidenced by jowls and nasolabial folds.  These combine to create a rectangular shaped face.

  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation using a dermal filler (I prefer Restylane Lyft) or with cheek implants for a permanent enhancement will create full, round cheeks anteriorly that will feminize the entire face.

 A weak chin creates an imbalance making the nose appear larger, the lower face short and the mid face appear top heavy while de-emphasizing the lips and allowing early "double chin" formation.  Chin augmentation, using a chin implant, will add projection to the chin creating harmony and balance to the lower face.  I have found placing a silastic chin implant through a small, curved, incisions under the chin to be very safe, quick, highly effective and far less invasive than a sliding genioplasty that requires bone cuts with placement of screws and metal plates.  I perform chin implant surgery, in 30 minutes or less, often using a local anesthetic alone.

 I tell potential facelift patients to think of creating a more beautiful or handsome face by working on three tissue levels.  The bony structure should be appropriate to make a woman’s face heart shaped and a man’s face chiseled and angular which is described below.  Next the fatty layer should be reduced or shaped allowing the shape to be seen and finally excess SMAS and skin evidenced by the presence of jowls) should be removed from the face and neck.

 Jowls are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured.  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, deep plane and subperiosteal facelifts) but with these added benefits:

•very small incisions
•minimal tissue dissection = less bruising and swelling = rapid recovery
•can be performed in 90 minutes or less, with or without anesthesia
•no incisions within the hair = no hair loss
•excess fat can be removed
•excess skin removed
•cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
•most patients fly back home to parts all over the world in as little as 3 days post-op

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.