59 years old- What would be the best treatment to treat my jowls? (Photos)

Question

I am turning 60 in a few weeks. My granny and my mom had the same jowels I am now seeing in my thin face. Recommendations??? I lost 30 lbs slowly but I feel saggy all over my face. Please provide best advice to rectify this.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Sam Speron, MD, FACS · Answer

Hello and thank you for your question and pictures!  A Mini Facelift can usually be an option on most realistic patients anytime after the age of 35-40. It really depends on your anatomy and genetics. It is best to talk to your surgeon because everybody has different techniques and recovery time is usually based on a number of factors. If we are just talking about a short scar facelift, this can typically be done in the office under local anesthesia. I strongly feel that it's very important to have an honest conversation with your surgeon about your particular situation, lifestyle, work environment and specifically which procedures you're having done so that you both have the most honest answer about your recovery and are realistic with expectations and results. Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the jowls.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Nelson Lee Novick, MD · Answer

First, congratulations on the weight loss. A robust HA filler injected appropriately to the upper outer cheek region would help to provide cheek projection and volume and create a more oval, heart-shaped face. Likewise, a robust HA filler injected appropriately in the region of the posterior angle of the mandible would help to straighten and define the jawline, lessening the jowl formation there and even to some extent improving the upper neck region immediately below below. A less robust, more cohesive HA filler fanned through the region immediately around the mouth would help to lessen the crepeyness and parallel laugh lines that are visible in the profile photo. And finally, an even lighter HA skin booster could be injected in the next region to diminish the cords and crepeyness there. Be wary of the claims you will no doubt encounter for the purported benefits of relatively expensive fraxel lasers, RF or ultrasound devices. Unfortunately, the hard science to date to support these claims lags woefully behind the advertising and media hype that promotes them. Make sure to consult with a board certified cosmetic dermatologist and ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

Begin Anew Med Spa · Answer

Hello! I think you would benefit greatly from Morpheus 8. It works by creating micro-tissue injury in combination with radio frequency to stimulate collagen & elastin. In doing so, it can result in skin tightening of the face.

Camille Cash, MD · Answer

For the best result you will want to consider a lower facelift.  Other treatments may give you some minimal improvement, but based on the laxity of the skin they likely will fall short of expectations.  The next step is to visit with a board certified plastic surgeon near you.

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
Congratulations on your weight loss!
From your photos, I note lax skin involving the lower 2/3 of the face from the cheek (malar) eminences to the jowls. There is also cervical banding resulting from neck skin laxity. There is also a degree of laxity involving the skin of the upper and lower eyelids.
As one ages, one's face loses volume and the overlying skin envelope tends to loosen. In addition, sun exposure and the downward pull of gravity will eventually result in loss of skin elasticity. Similar to an old rubber band, it loses its ability to contract. The loose redundant skin may hang in folds.
Due to the extent of the sag, correction would require a full face and neck lift as well as upper and lower blepharoplasty.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...