What are my options for sagging jowls at 34? (photos)

Thank you for your question and pictures.  You would be a great candidate for a lower facelift and necklift.  
The facelift I perform is under a local anaesthetic which means a significantly reduced downtime.
Most of my patients want a facelift however do not want the downtime associated.  The Concept Facelift and Necklift is the procedure I perform, which combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days. 
If you have lax facial skin, lost volume and feel that you have jowls and wrinkles on your cheeks and you look tired when you're not then the concept facelift can help improve your appearance. With concept facelift you will look natural and fresh just like the way you feel inside. There are no bandages, drains and hospital stay but with lasting results of traditional facelift techniques it fits with today's age.
 Typically recovery period is 7-10 days as you do tend to bruise more with your eyes than facelift and necklift.  You would need to return for a follow up appointment 7 days later to check your healing progress.  This can be combined with lower eyelid surgery which I think will give you a fresher appearance.
What are the benefits of a local anaesthetic facelift?
Minimally invasive as it is a short scar facelift, although has the same effects as the Traditional Facelift as the SMAS muscle is tightened along with the skin.There is minimal bruising and swelling, especially when compared to traditional faceliftsAs the procedure is performed under local anaesthetic, you can go straight home following the procedureFull recovery in a matter of days rather than monthsSignificantly less risk than Facelifts performed under general anaestheticFresh, youthful and long lasting resultsPlease make sure you find a reputable and qualified plastic surgeon

Hello and thank you for question about your jowls and for your many photos. While your symptoms are mild, they clearly are a concern for you, and one which you can address in many ways. Due to your age and the mildness of your symptoms, a facelift and even a mini facelift can still be delayed for many years. There are several options for you including noninvasive skin tightening procedures such as Ultherapy and Thermage, suture lift such as Silhouette InstaLift and even a filler procedure which can help create evenness along your jawline and help improve the appearance of skin laxity.  Get several recommendations from board-certified facial plastic surgeons in your area and see before-and-after photos of their past patients before proceeding. Good luck! 
- Jacqueline T. Cheng, MD

Thank you for your question and providing images. You're still young and would not need something as drastic as a facelift. I would recommend something a little less invasive such as PrecisionTx which is a laser-assisted liposuction that will not only eliminate the pockets of fat but will also tighten the skin in that area. Good luck! 

Thank you for your question. At your age, you should consider less invasive options. A temporary option is to hide the jowling with some filler along the jawline. Patients tend to find this unsatisfying in the end and seek more permanent options. I am usually not a fan of liposuction in the face (except in the neck, where it works well), but a microliposuction of the jawline under local anesthesia would be a quick and effective solution for you with minimal downtime.

You do not yet have enough sagging to justify a facelift. Concentrate on preventing sun damage by protecting your skin with sunscreen, hats and clothing. Have your dermatologist recommend a medical-grade skin care regimen with retinol and hyaluronic acid. Get regular chemical peels. If you do start to see some jowling, a mini lift, with or without a neck lift would give improvement. I hope this helps.

You appear to be in the very early stages of aging with volume loss in your mid face. I would recommend the volume enhancement using a number of techniques ranging from fat to synthetic fillers. 
Once facial aging progresses to skin laxity and dissent, I recommend a micro or many facelift. I have found that patients who get treated surgically sooner end up looking better longer.
Sincerely, 
Philip J. Miller, MD, FACS
Double Board Certified Facial Plastic Surgeon