Surgery the Only Option for Sagging Jowls?

I'm a 41-year-old woman with fairly good skin, but I have slightly sagging jowls. Is surgery the only skin tightening option for this?

Doctor Answers 3

Non Surgical Options For Sagging Jowls

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Thank you for your question. For patients in their 40"s with minimal sagging of the jowls the non surgical options include:

  1. Botox or Dysport to Treat the DAO Muscle-this muscle pulls the corners of the mouth down and creates the crease in front of the jowl-relaxing the muscle can lessen this fold
  2. Filler injection into the fold (Marionette Line) in front of the Jowl-There are many fillers, I use Perlane but Sculptra, Juvederm, Restylane and others may be used. This technique plumps the depression in front of the jowl and camouflages the jowl
  3. Non surgical skin tightening-There are many techniques available including Thermage, LuxIR Deep, Titan, Ulthera and others.
  4. Laser Resurfacing-Combined Laser Skin Resurfacing using 1540 non ablative and 2940 ablative fractional Erbium Lasers can tighten facial skin and improve minimal jowling

See a board certified Plastic Surgeon who is experienced at these techniques. Some call them the "Liquid Facelift."

Surgery the Only Option for Sagging Jowls

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It's difficult to assess online without photos to view. Depending on the level of laxity, the effects of a neck lift will certainly outlast the effects of non-surgical treatments. Non-surgical procedures can only temporary resolve the issue and require few to several attempts or treatment appointments. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine if you are a #candidate for #rejuvenating the neck. During an in-person examination, your chin will be evaluated along with the neck and jawline. 

Also, if deemed a candidate, you may want to consider Lite-lift™ which is an affordable, quick, and effective innovative facelift developed by board-certified plastic surgeons Dr. Larry Nichter and myself. The goal is to provide a less invasive natural looking option for both men and women desiring to refresh their appearance with less downtime and risks. The LiteLift® is a “real” facelift, which does address the underlying muscle, tissue and overlying skin.

This is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.

A board certified plastic surgeon should evaluate both your anatomical features and aesthetic goals to suggest which procedure best suits your needs. In some cases there may be more than one option to choose from. If you are not a candidate at the time of your #consultation, your board surgeon can recommend non-surgical alternatives to address your concern.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Skin tightening procedures

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This is an excellent question that, as a facial plastic surgery specialist, I get asked on a daily basis. There are several options for sagging jowls in someone in their early 40's. The most conservative treatment is to mask the appearance of the jowl by filling the creases around the mouth. Usually using a hylauronic acid filler such as Restylane will serve this purpose well. These fillers usually last about one year.

Second, if the skin is not sun damaged and still retains its elasticity, then liposuction may be an option. This usually is a good treatment for someone who is young and has elastic skin. Most people however, do not fit into this category because the appearance of the jowl itself is a sign of the skin losing elasticity.

The best and most long lasting treatment is a lower face lift. This simple procedure will combine liposuction with a lower face structural lift to "put the jowl back into its proper position." This lift is long lasting and gives fantastic results.

Finally, many patients also ask me about laser skin tightening. I usually tell patients that lasers are unable to "lift" the skin. They can provide some skin firmness, but will not lift the jowl to any degree. Although you may see many companies claiming that their laser can perform this task, I am hesitant to believe it. I have seen too many unhappy patients who have had many many laser treatments with little to no noticable result.

Thanks for your question.

Henry Daniel Sandel IV, MD
Annapolis Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.