What is my best course of action for jowls in a 40-year old? (Photos)

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.​ Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Generally, there are three options for cheek enhancement in a 40 year old: facial filler injections, fat transfer, and cheek implants. Many patients may have relatively flatter cheeks from youth, which becomes flatter with age. Defined cheeks can be achieved with or without surgery. Speak with a plastic surgeon who can review various options with you. Read more in our blog post below.potomacplasticsurgery.com/blog/category/cheek-augmentation/Best,Dr. Chaboki

A mini facelift is a great option for many people to address sagging jowls. The recovery & downtime is very minimal. There are usually no drains, most people can go out the same day, you can shower the next day, there're no scars behind the ears and you can wear your hair up anytime and most patients take no pain medicine. There are never any guarantees of course with any procedure whether it is surgical or nonsurgical in nature. I'd recommend not getting into the mindset of thinking the jowls or neck skin will be 100% gone with a mini facelift or neck lift as this might lead to disappointment. It is always best to consider that an area will be improved and discuss how much with your plastic surgeon. 
Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the neck and jowls.
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 mini facelifts and neck lifts 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 an idea of the pros and cons to each of them as well as realistic expectations. 
I hope this helps. If it does, please take a moment to up vote this answer on the “respond” button on the top right.  Have a great day.

Hello and thank you for your question. Based on your
photograph, you are a great candidate for malar enhancement.  This can be
done in one of two ways.  Voluma is an injectable filler which can be
injected into the malar region as a temporary filler.  Malar implants can
be placed as a permanent way to gain volume in the cheek.  I always use
medpor implants with screw fixation.  Silicone malar implants tend to
have a high rate of malrotation over time.  I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Thank you for the question. This has been a question that is very common. The early signs of aging but not quit ready for the facelift. Until recently we recommended fillers and/or the lower facelift. However you would be an excellent candidate for a newer treatment: Embrace RF, which uses bipolar radio-frequency both under the skin an on the surface. It is a combination a Facetite and a Morphious8 procedure.This will tighten the face and neck, significantly improving the jowls and jawline. It would benefit you to speak to a facial plastic surgeon with this capability. Review the web link below for information.

Fillers are an option. They are typically considered "minimally invasive" as no true incision is required. Be cautious not  to overfill your cheekbone region. Too many injectors are overfilling in my opinion... and patients just look distorted. Share your concerns with a plastic surgeon and after a full and careful consultation you may find the filler option desirable.

 Hi, I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  From the photos, there are mid-cheeks grooves indicating an underlying lack of cheek bone volume which allows the cheek tissues to sag towards the nose and mouth, there is excess fat in front of and below the cheeks, jowls are present and the back portion of the jaw line is weak.  These combine to create an elongated, rectangular-shaped face.
 The reality is, there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance).  Price is determined by the reputation, location and experience of the Facelift Surgeon.
 In my humble opinion however, there are some basic requirements that must be met in order for a facelift to be "effective", yielding "aesthetic pleasing" and "naturally attractive" results.  These include: 
 1. Some type of incision either curved around the front (preferred) or straight in front of the ear.  This is how excess skin is removed which is not possible with an incision behind the ear alone.  If you have so little excess skin on the face that "none" needs to be removed you are not a candidate for a facelift in the first place.
2. The facelift must address correction and softening of the "jowls" using a long lasting and effective technique.  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
3. Facial shaping must be combined to properly shape the cheeks, chin, jaw line and lips for feminizing or masculinizing the face as the case may be.
 In my experience, this is the "key" factor in making the face soft, feminine and naturally beautiful.  An essential part of any facelift on a woman.  Conversely, men look chiseled and handsome when angularity is created in the cheeks, chin and mandibular angles.  The ability to provide precise, facial shaping separately or in combination with a facelift is in my humble opinion the definition of a "facial shaping expert".
 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)can be performed in 90 minutes or less, with or without general anesthesiaproper SMAS Imbrication techniqueno incisions within the hair = no hair lossexcess fat can be removed from the face and neckexcess skin removed from the face and neckcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-op I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  When the front portion of the cheeks are either flat or concave, cheek augmentation with a dermal filler or using silastic cheek implants (permanent augmentation) can create full, round cheeks that will feminize the entire face. Liposuction can reduce excess fat to further shape the cheeks, neck and face.  Liposuction can reduce excess fat to further shape the cheeks and face.
 It's important to keep all of these "heavily marketed" non-invasive skin tightening procedures in the proper perspective.  Non-invasive techniques typically shrink the skin several mm's.  There are 25.4mm's in one inch.  The minimally invasive facelift described here can remove 2 to 3 inches of skin which equals 50.8 to 76.4 mm's or up to 25 times the amount of loose skin provided by non invasive techniques.  That reality should always be front and center in the decision making for prospective facelift patients.  It should also be noted that non invasive techniques have no ability to properly dissect, elevate, trim and re-suture the SMAS layer making them one dimensional at best. Hope this helps.

Hi,You have minor jowling, however, at your age the jowls will continue to droop. You could have a mini-jowl lift under local with mild sedation which will improve the jaw line and decrease the rate of drooping. Best,Dr.S.