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

Question

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.

James Shire, MD · Answer

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.

Jason Emer, MD · Answer

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.

John J. Martin, Jr., MD · Answer

To address these areas you would need a surgical face lift.  That will help to elevate the cheek, and diminish the jowls.   If you don't want surgery, Ulthera would provide some tightening of the jowls but would not give the result that a facelift would.

Zoran Potparic, MD · Answer

Based on your photos it seems that face and neck surgery with fat grafting around cheeks, eyes and chin may be a good and long lasting solution for you. It is not going to produce too much change but it will address jowls, jaw line, lower face and cheeks.  I am not sure that you will need submental (bellow chin) incision. In experienced hands it is much more simple surgery then many patient anticipate.  It will provide natural looking, long lasting result (10-12 years) that will ultimately end up being more affordable then "maintenance" that you are currently paying for. Good luck.

Harry V. Wright, MD · Answer

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

William Portuese, MD · Answer

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

Ben Talei, MD · Answer

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.

Darryl J. Blinski, MD · Answer

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.

Sean Freeman, MD · Answer

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!

Lee A. Gibstein, MD · Answer

Thank you for your question and photos. The answer to your question is somewhat complicated and difficult to answer without seeing the full extent of your cheek. You mentioned that you want a non invasive solution but permanent one. Fillers can improve the contour of your face and help the appearance of sagging cheek and jowl areas. There are no approved permanent fillers on the market in the US and you should always remember that if a permanent fillers is utilized and you are not happy with the result you now have a permanent issue. Fillers are relatively non invasive but do have limitations as to their ability to lift the cheek and jowls. A facelift would give a more comprehensive change for you and much longer lasting result but is a surgical procedure and therefore more invasive. I would highly recommend a consultation with a board certified plastic surgeon who has significant experience with fillers and a practice that focuses on facial aesthetics both surgical and non-surgicalBest of LuckDrG

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