Lower Face Sagging - what non surgical procedures will help? (Photos)

Question

What procedures would you use on my lower face? I have had a mini facelift, and it did not address the jowl area. I would prefer to not have surgery at this time.

William Portuese, MD · Answer

The photographs you presented a rather limited, but it does appear that you're a candidate for a lower face and neck lift procedure. This procedure. accomplishes, lifting the jowls, tightening  loose facial and neck skin, and tightening the neck muscles and three locations. Unfortunately, a mini lift only offers mini results. Study the before, and after photographs of your prospective facelift surgeon to ensure that you're getting natural results.

Nelson Lee Novick, MD · Answer

At least from the photos provided, it would appear that the use of a robust HA Contouring Filler placed in the region of the posterior angle of the jaw, as well as along the jawline would help to better straighten and define the jawline. This can be accompanied by the targeted use of small bolus amounts of Botox spaced along the upper and lower jawline and upper neck to further tighten the jawline and upper neck regions. Both procedures can be performed in one treatment session or in two separate sessions, if so desired. In experienced hands, each treatment approach typically takes no more than about ten minutes and usually engenders little to no significant post-treatment downtime. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist injection expert.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photos. Based on what I can appreciate, the primary concern appears to be mild-to-moderate jowling and loss of definition along the jawline, which is often caused by a combination of tissue descent, volume loss in the midface and temples, and gradual collagen loss in the skin.

One important point is that if a mini facelift did not fully address the jowl area, that does not necessarily mean non-surgical treatments won't help. It simply means that we need to identify which factors are contributing most to the sagging.

If you were my patient, I would likely consider a combination approach rather than relying on a single treatment:

1. Strategic Filler Placement (Not in the Jowls Themselves)
One of the most common mistakes is placing filler directly into the jowl area. Instead, restoring support in the cheeks, temples, and along the jawline can create a lifting effect and improve facial balance. Sometimes a surprisingly small amount of filler in the right location produces a more refreshed appearance than larger amounts placed in the lower face.

2. Biostimulatory Injectables
Products such as Sculptra can be excellent for patients who have experienced gradual volume loss and skin thinning. Rather than acting as a traditional filler, Sculptra stimulates your own collagen production and can improve facial structure over time while maintaining a natural appearance.

3. Skin Tightening Devices
For patients who prefer to avoid surgery, treatments such as ultrasound-based tightening or radiofrequency-based skin tightening can help stimulate collagen and improve mild skin laxity. These treatments are not a replacement for surgery, but they can provide subtle tightening and help maintain results.

4. Jawline Contouring
In some cases, carefully placed filler along the jawline can camouflage early jowling and restore a sharper mandibular contour. This is often particularly helpful when the jawline has lost definition despite previous surgical treatment.

Looking at your photos, I do not think you appear to need excessive volume. In fact, I would be cautious about overfilling, as that can create a heavier appearance and sometimes make the lower face look wider rather than more lifted.

My overall impression is that your best non-surgical improvement would likely come from a combination of collagen stimulation, targeted structural support, and skin tightening rather than simply adding volume directly where the sagging is visible. The goal is to restore support from above and improve skin quality while preserving your natural facial contours.

Lower Face Sagging - what non surgical procedures will help? (Photos)

Answers (3)

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