33 year old starting to get jowls. Help! (Photo)

I treat this everyday in my practice. You may be a surgical candidate but you do not need surgery for improvement. Properly performed liposuction with energy based devices and physical fat removal will do fantastic to remove the fat, lift the skin, and contour the jawline. I pretreat everyone with Botox 1-2 weeks before surgery to relax the neck muscles, allowing for better retraction of the skin after surgery. Then after treatment we do skin tightening with Venus Legacy to improve the results and decrease the neck swelling. I suggest you only see an expert for treatment of this area as a meticulous surgeon is required to get great results and complications in this area can be devastating both medically and cosmetically. A new medication that is used to remove chin fat with injections called Kybella may also be an option, as it secondarily allows for skin tightening/lifting as well. Fillers can be used to contour the area and skin tightening devices like ultherapy/thermage to tighten.  A formal consultation is needed to determine what are the best options for you. Best, Dr. Emer. 

Jowls develop as a result of facial volume loss which may be what is responsible for your situation. You may be interested in a similar case involving a patient from my office at the Dr. U Clinic who also wanted to get rid of early jowls. See the link below. She received treatment with a dermal filler called Radiesse. Radiesse is used for a wide range of non-surgical facial contouring applications. This includes the nose, cheeks, chin and the lifting/reshaping of mild to moderate jowls. The calcium-based particles also stimulate the formation of your own collagen, instead of just dissolving as it is metabolized by your body. 

Liposuction of the jawline/jowls would improve the problem very easily and quickly with only 1 day downtime and you can drive yourself home.

Great Question. Jowls are a very common complaint we receive in our office on a daily basis. If you are specifically concerned about the Jowl area, I would recommend getting a consult for a procedure called Ultherapy which uses Ultrasound technology to deliver heat to the tissue. The heat stimulates collagen rebuilding. The lower face is a great area to do this as it provided lifting and tightening of the skin and help correct jowl formation. There are also various filler such as Restylane Lyft or Juvederm Voluma that can be placed in your mid face that can provide lifting of the aging skin. I would recommend you see a board certified dermatologist or plastic surgeon who has experience in these procedure.

Thank you for your question and photos.It looks like you started getting early signs mid-facial fat compartments deflation and gravitational ptosis (sagging). Every individual will have those changes of face depending on their life style, weight fluctuations, genetics.You might consider following: Volume re-balancing with filler or Sculptra injections - those will reinforce you face at so called 'anchoring' points to support sagging tissues.Tissue/collagen retracting treatments like radio-frequency or ultherapy -technology based treatments.More radical solution would be MFL using pulling threads and re-positioning sagging fat and soft tissues. This obviously more of a surgical procedure and has more risks, but more likely to help the problem.

  Hi based upon the attached photos your cheeks are concave anteriorly (in the front), the chin is weak, there is some excess facial fat below the cheeks and there signs of jowl formation.  These combine to create a rectangularly shaped face.  Women look the most attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round anteriorly.  Cheek augmentation with a dermal filler (I prefer Perlane) or using cheek implants for a permanent enhancement can create full, round cheeks anteriorly that will feminize the entire face. When the chin is weak, this mkaes the nose appear larger and the mid face top heavy.  Chin augmentation with a dermal filler (I prefer Radiesse), or using a chin implant for a permanent enhancement, will add volume to the chin creating harmony and balance to the lower face.  These should be done in concert and at the same time as a facelift.  If you have "jowls" this is sagging
facial tissues and an indication for some form of a facelift.  The underlying SMAS layer, of the face, must
be dissected, lifted, trimmed and re-sutured. The excess skin is then
removed and the facelift incisions closed.



My most popular facelift is the minimally
invasive, short incision facelift that has all the benefits of more invasive
facelifts (traditional, mid-face and subperiosteal facelifts) but with these
added benefits:



•very small incisions

•minimal tissue dissection = less bruising and
swelling = rapid recovery

•can be performed in 90 minutes or less, with or
without general anesthesia

•no incisions within the hair = no hair loss

•excess fat can be removed

•excess skin removed

•cheeks, chin and jaw line can be augmented with
dermal fillers (I prefer Perlane) or facial implants

•most patients fly back home to parts all over
the world in as little as 3 days post-op

Hope this helps.