How can I tighten up the skin around my jawline? (Photo)

Question

I lost 25 lbs about 2 years ago. I am 38 years old. What can I do about my sagging skin. Most people my age don't have it this bad. I don't drink or smoke. I have had fillers and botox.

Paul Lanfranchi, DO, FAOCOO · Answer

Thanks for sharing with the community.  Unfortunately some individuals are genetically predisposed to age faster in the lower face than others.  In addition, having lost significant weight only accelerated the issue and drooping.  Assuming your physical exam matches what we see in your photo, I would expect that you would qualify for a lower facelift and necklift. Mind you, there is not definitive age to have a lift...some have it in their 30's, others in their 80's!  Most important is that your procedure is preformed technically well so that in 10+ years you can do it again if you wish.  I would also suggest finding a PS that offers this procedure under local anesthesia (as we do here in our Center).  Performing a lift under local is safer (and less expensive) than having it done under general anesthesia.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and pictures.  Unfortunately, when people experience a large amount of weight loss their skin will lose elasticity due to being stretched.  This can cause patients to have more of an 'ageing' appearance.  You would be a good candidate for a lower facelift and necklift.  This would target the SMAS muscle and remove the lose skin making the jawline and neckline smooth.  This would give a youthful appearance.  All The Best

Sam Speron, MD, FACS · Answer

Congratulations on the weight loss and getting healthier and being medically optimized! 
Usually when there is excess skin from weight loss, removing that skin is the best option.There are various combinations from a mini facelift, mid facelift, and neck lift that can address different areas. There are never any guarantees of course with any procedure whether it is surgical or nonsurgical in nature.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.

Tanveer Janjua, MD · Answer

The best option is to do a necklift which is similar to a facelift and pulls back all the extra skin and can be combined with a liposuction as well for the jowls. The second best option is to do liposuction with Thermitight. It has very little down time.Compare both procedures and see what is best for you. Regards Dr.J

Jason Emer, MD · Answer

I suggest getting a formal evaluation with an expert to determine the best solution for you. If you're seeking out a non-surgical approach, FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend consulting with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Larry Weinstein, MD · Answer

After your weight loss the skin has sagged and has been stretched out. The elasticity of your skin cannot be completely restored. The best way of making you look younger for an extended period of time is with a facelift, jowl lift with SMAS. The underlying tissue should be elevated and the excess skin trimmed to get your best long lasting results.

Alicia Sigler, MD · Answer

Hello and thank you for your question. A great way to get rid of that sagging skin would be a facelift. Please consult in person with a trusted surgeon to discuss your options. You would have great lasting results from a procedure such as that.

Michelle Zweifler, MD · Answer

Botox and fillers are the usual starting points for facial aging. A lower facelift or mini-facelift with help tightened the jawline, reposition SMAS deeper tissue and remove excess skin. It helps get rid of the jowls and sagging.

Dilip D. Madnani, MD, FACS · Answer

Thank you for the picture! It appears that you have lower face skin laxity in both the jowl area and your neck.  You have options varying from nonsurgical to surgical with the surgical options being the most long lasting and beneficial. You are looking down which can exaggerate the looseness in the neck and the weightloss can also exacerbate the laxity effects if the skin does not retract. Non surgical- there are multiple options such as ultherapy or other energy based devices that can give you some tightening in the lower face area- during the consultation process, I tell my patients that they can expect about a 20% tightening vs what can be achieved with surgery. The advantage of this is that there is no downtime as long as the expected results for you are understood.Surgical options for you would include some type of lower facelift with neck lift, you may also want to consider a buccal fat removal as well to further improve the lower face contours.

Edwin F. Williams, III, MD · Answer

I see and hear your concern.  In the long run, surgery in the form of a lower face and neck lift is the treatment option that will provide the most value to you (in terms of good result, long-term effect, financial cost, and time spent).  You can certainly try nonsurgical options first.  However the nonsurgical options do not provide much value in this area, and the time/cost tends to add up over time.  Hope this helps!

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