I’m 47 years old and my jowls/lower cheeks started to sag. What's the best surgical procedure? (photos)

This is a great question that I hear a lot from my patients. A short scar facelift addresses the jowls & marionette lines. This procedure can typically be done under local anesthesia in the office, patients are up and moving around the same day.

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 never be pushed out with just one suggestion. Ultimately there are pros and cons to every procedure whether it's surgery or not surgery. It should always be your choice.

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.

Thank you for submitting your question and photos. You may be a candidate for a facelift procedure to reduce the appearance of lines and jowls, lift fallen tissue, and define the overall shape of the face.
This surgical approach can correct midface sagging, jowl formation, and marionette lines by lifting tissue and muscles upward in the cheek and outward in the neck. In some cases, excess fat is also removed to create a more defined and sculpted appearance. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can assess your concerns and suggest the best approach to address them.

Liposuction under local with the micro canulas and FacetiteRF and Morpheus would give a beautiful jawline and neck and is so easy to undergo with only 1 day downtime for roughly $4750.

Thank you for the photos and your question. From the views provided I see fullness of the lower face and with a shadow extending from the corner of the mouth down to the jawline. Surgery could be planned to reduce fullness by removal or repositioning the volume in the lower face (liposuction and or lower facelift). Additionally, I suspect adding volume to the chin and cheekbones with liquid (fillers) or solid (silicone) implants would be recommended to enhance the results by creating more balance, definition and support for the soft tissues. More photos or in person consultation would be helpful to determine the best options for you.

My Best to you,

Dr. Stephen Fink
Newport Faces Cosmetic Surgery
Newport Beach, California

For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. Botox and radiofrequency can help slim and contour the jawline. Ultherapy, J Plasma and RF treatments can provide skin tightening and lift. I would recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer​

You have a variety of solutions depending of your desire for surgical intervention. If you don't want surgery, you could try a variety of fillers to camouflage the situation. This will be a temporary solution. Non surgical skin tightening is another option but results will not be long term. If you are ready for surgery, a facelift might be your solution.

There are a number of surgical and non-surgical options that can improve one's cosmetic appearance: fillers, skin-tightening procedures, lasers, fat contouring, and face lifts. Each
has benefits and drawbacks. Mini procedures do not produce the long lasting maximum improvement that is achieved with a natural appearing artistically performed lift performed by an expert experienced plastic surgeon. That is achieved by a combination of elevating the sagging tissues, removing the excess skin, contouring the fat, and adding micro-fat grafts or fillers where there is a deficiency.

Keep in mind, that following the exact advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the proposed operative procedure may not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS
La Jolla, California

A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. The goal of a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, remove fatty deposits in the neck and lift the jowls. The limited photographs presented demonstrate a recessive chin profile, so consider placement of a small chin implant