I'm developing slight jowls at 40. Any suggestions? (photo)

Question

Hi. I am 40 years old and I am noticing slight jawls on my face. I think it is in the family also as my mother had them since I remember (she is 70 now though). I think it is mild at this point but what can I do to reverse what I have and prevent even more from happening?

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Ross A. Clevens, MD, FACS · Answer

Dear Sunmist,Wrinkles and jowls are the result of the aging process. Your skin looks nice in this picture, and I would suggest staying out of the sun and reducing alcohol consumption to continue to begin reversing the jowls. A Weekend Necklift can remedy your concerns in less procedural time and recovery time than many other procedures. You may also be a candidate for facial plastic surgery in a decade or so, as 55years old is a common age for many women to begin exploring face lifts. I suggest you consult a local board certified facial plastic surgeon to receive the best face-to-face input and to begin moving forward in your decision-making process.Sincerely,Ross A. Clevens, MD, FACSClevens Face and Body Specialists

Raymond E. Lee, MD · Answer

Hi and thanks for posting your question and photos. At 40 one starts to see some loss of fat and descent in the mid face. Your photo is cut off so hard to see the whole story. What I do see is that you do not have any jowling but fullness in the Buccal fat area or the lower cheeks. I'm not sure if you need any skin tightening devices. In my opinion some filler to the mid face and Buccal fat reduction would be what you need to get back the look you want. Of course an in person exam is needed to recommend a definitive course of treatment. Best of luck!

Trefor Nodwell, MD · Answer

Good afternoon and thanks for your question and photograph.Depending on the specifics of your exam and a more detailed understanding of your concerns, it's likely you could benefit from a number of non-surgical and minimally invasive procedures to help maintain a youthful jawline for years to come.Many patients in their forties with your concerns opt to undergo a combination of treatments including skin tightening with radio frequency (Thermage) for the neck and jawline and injectables like Voluma in the area just in front of the jowls.Of course an ounce of prevention is worth a pound of cure so I would recommend to all patients that they not smoke, avoid excessive sun exposure and maintain a healthy diet and weight.A medically supervised skin regimen that includes alpha hydroxy acids, retinoids and growth factors can add to the longevity of the result.Start with a face to face meeting with a certified Plastic Surgeon and the specifics of your treatment plan will become more clear.Best of luck with your research.

Timothy R. Miller, MD · Answer

Your degree of face/neck laxity is very minor based on the attached photograph and better recommendations can be presented with more photographs and, of course, through an in-office examination of the area.However, for the beginning stages of facial laxity non-surgical Ultherapy (micro-focused ultrasound) treatments and/or targeted volume augmentation procedures with fat transfer or syringed based fillers (e.g., Voluma, Radiesse, Juvederm) may provide correction of your concerns.The attached link and website provides more information on Ultherapy.I hope this helps.

Josh Surowitz, MD · Answer

Thank you for your question.  Your photo is somewhat limited in what it shows and additional photos of the profile (side) and three quarter view would be helpful.  Also, it would be helpful to see the full detail of your cheeks.  Based on your photo, you really have more buccal fat fullness than jowl formation.  You also appear to have some slight volume loss in the cheeks.  Augmentation of the cheek volume with conservative buccal fat reduction would likely give you very nice results.  You do not appear to be a candidate for facelift or neck lift.  Consult with a facial plastic or plastic surgeon.  Good luck!

David Q. Santos, MD · Answer

The picture suggests early aging changes that every one gets and noted here is mild jowl formation.   At age 50 to 55 this will be more pronounced.  Subcutaneous laser probe laser Lipolysis can help to reduce the fat and help tighten up the jowls.  This can achieve a mild and subtle change but won't resolve the jowls.  Facelift provides greater improvement to this area.

Curtis Perry, MD · Answer

You are a great candidate for minimally invasive procedures. My preferred treatment for skin tightening is ThermiTight which could be used to tighten the jowls and the skin under the chin.. Synthetic fillers or fat transfer artfully placed in areas such as in front of the jowls

Todd C. Miller, MD · Answer

Hi Sunmist, from the picture that you provided you appear to have a nicely defined jawline and neck with minimal if any jowling. The beginning stages of facial aging are typically treated with less invasive options such as fillers or fat to address areas of volume loss, and tightening procedures such as Ultherapy to address areas of slight laxity. I would follow up with an experienced facial plastic surgeon who can present you with options that will give you a noticeable improvement.

M. Dean Vistnes, MD - Account Suspended · Answer

Please seek an in person consultation, you may be a candidate for simple liposuction of the area. Liposuction of the cervical facial area is usually done in one hour under local IV sedation. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those that have realistic expectation on what a procedure will and won’t do for them. Good luck! Dean Vistnes.

I'm developing slight jowls at 40. Any suggestions? (photo)

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