What can be done about jowls in a 34 year old? (photos)

Question

I've always had a low-set chin (double chin) and larger protruding cheeks "jowls" since then was a little girl. I feel that it really distracts from an otherwise pleasant face. Both my parents have it, and as they've grown older, it's become very pronounced. I'm not at all over weight. Is 34 too young to have surgery? What kind of surgery would need to be done? A mini facelift? Would I need liposuction as well? What can be done with my facial anatomy to give me a more defined, sleek, jaw line?

Alejandro Nogueira, MD · Answer

Your jowls, double chin and overall soft-tissues flaccidity are due to poor skeletal development at the chin which, beeing ok in the horizontal width, is too small in the anterior projection and too short vertically; you are an optimal and undisputable case for a two-dimensional genioplasty with bone grafting supply (elbow or hip as donors). Never a chin implant may produce such two-dimensional effect or any soft-tissue re-stretching, besides the prosthesis at the chin are not only disappointing in their results but also lead to a series or complications making them outed sooner than later. Fillers are a total hazard for your health and beauty, will not even comment on them. Liposuction? what of? would be moneysuction only and very likely an irreversible deformity, there is no fat that can be extracted from your slim and youthful face.
Do research well and follow the advise of a well-trained surgeon with experience in osseous genioplasties, the results are awesome, safe and for a lifetime.
Better images are required to provide overal assessment of your case.
Feel free to request any additional information from me.

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.

Ron Soltero, MD, FACS · Answer

dear Patient: thanks for your question and your photos!  After 18 years performing Plastic Surgery and particularly Facial Plastic Surgery, there are two ways you can proceed to achieve your desired results.  You can start with Fillers, injecting Voluma (which is a more cohesive hyaluronic acid) for the cheeckbone area, this will help with improving your sagging in jowels. You could also try Kybella injections in your neck area, they are supposed to dissolve the fat in that area.If you want a more drastic change, You could have liposuction in your neck area, Buccal fat removal Fat Transfer to your cheeckbone and  a chin implant to balance your face and create a natural looking result.I would suggest you always consult with Board Certified Plastic Surgeons, and start with a non- surgical approach first.  I always advice my young patients to try out the fillers first, and if the outcome is not as they expect thy then can have more invasive surgery.  It is very important for you to let your surgeon know what are your exact expectations so the surgeon can match them with a possible outcome that is realistic.Hope this helps!!!!

Luis A. Vinas, MD · Answer

you are a great candidate for fillers. You can camouflage the Joel's by injecting in the front snd behind it to make it smooth. You csn Aldo augment the chin and the depressed cheeks for a mor balanced and youthful look. The other option is Ulthera pt or fractionated erbium to tighten the jowls. Thanks

Thomas Buonassisi, MD · Answer

Hello and thank you for your photos,
I do see patients in their 30s for facelift surgery but it certainly isn't the norm. Typically these patients have inherited certain facial features that contribute to them developing jowls and jaw line laxity at a young age. You are pretty and probably notice these features more than anyone else. Although you could consider surgery, there are some non surgical things you could consider as well:
Dermal fillers: project your chin a little more, which will give the illusion of a longer jawlineDermal fillers: fill the area just below your mouth, on either side of the chin, which will give the illusion of blending the jowl a littleSurgical options
Because you are young and appear to have good skin condition, you could consider a mini lift. There is a link below. The mini lift is a smaller type of facelift that has shorter incisions. Only an in person consultation would tell, but this procedure might be sufficient to tighten the jawline and jowls. Please keep in mind that the incisions are customized for the patient, depending on the goals.Chin implant, if you decide to go the surgical route, placing a small chin implant could improve the result of the mini facelift.All the best,
Dr. Buonassisi

What can be done about jowls in a 34 year old? (photos)

Answers (5)