35 y/o concerned about jowls, would filler be the best option? (photos)

Question

Would filler help the jowls forming ? Or what would most effective treatment be. I'm 35 for reference. Thank you.

Nima Shemirani, MD · Answer

Hi @KristaR1987! I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. You would likely benefit most from RF microneedling to reduce jowl formation. This treatment option combines radiofrequency technology with microneedling to increase your body’s natural collagen production and restore your skin’s elasticity. RF microneedling tightens and contours the skin while also improving its quality and texture.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to assess your concern and determine the best treatment option for you.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to assess your concern and determine the best treatment option for you.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Gianfranco Frojo, MD · Answer

Filler only provides volume. The jowl is an actual fat compartment in the face that will only worsen by adding volume to that area. Sometimes injectors attempt to camouflage the jowl by injecting adjacent to it along the border of the jawline, this can be extremely problematic if not done correctly and overtime will only create a more challenging problem to fix. I would recommend a facelift/necklift to be able to appropriately thin the area with direct visualization and tighten those structures in addition to removing any potential excess skin. It is not uncommon for this to be done in patients that are your age even though many people think that this procedure is only for patients more advanced in age.

Giuseppe Fiore, MD · Answer

Hi,
Thanks for your inquiry and photos. 
In my opinion and based on my experience,  the best approach in your case should be the combination of dermal fillers on the upper and middle face to give structure and support to the lower face AND Radiofrequency procedure ( e.g. Face/Necktite and Morpheus 8 or Renuvion/J plasma) for tissue contraction ( fat and skin tightening) on the lower face (jaw line, jowls, marionette lines) and improve your contour and jaw line. After conducting a detailed facial assessment, I usually begin with dermal fillers to provide support on the middle and lower face and improve balance among different areas of the face. Jawline filler can be particularly effective in creating a more defined and contoured jawline, while cheek filler can help balance out any asymmetries or hollows for a more youthful and proportionate appearance. After 2 to 4 weeks, I typically start with Morpheus 8 (in some case 1 session of Facetite) , which involves 3 sessions spaced 4 to 6 weeks apart. In some cases, I may also combine Morpheus8 with Exilis Ultra 360 to improve skin tightening in the jawline and submental area. Morpheus 8 involves microneedling and Radiofrequency and could be quite discomfort at high level of energy for better results. For this reason, in my clinic , Morpheus 8 is performed by a doctor with experience in local anesthetic infiltration to reduce the discomfort. I recommend scheduling an appointment with a doctor/surgeon who specializes in dermal fillers and skin tightening procedures for a detailed evaluation of your facial anatomy and a customized treatment plan. 
Hope this helps,
All the best, 
 Dr. Giuseppe Fiore

Richard Zienowicz, MD · Answer

Hello and thank you for your question. Personally, I would recommend waiting until the jowling and other facial and neck aging is more severe before undergoing surgery. I would also avoid aggressive filler to the cheek and/or nasolabial fold and marionette lines. I think some conservative filler to the face will show some improvement however I would be wary of over-filling. I would focus on avoiding sun exposure, smoking, excessive alcohol and a good skincare regimen including a retinol and waiting a few years when surgery will give you more noticeable results. Ultherapy would be a good nonsurgical option for you as well that could offer skin tightening benefits. Best of luck.

Nelson Lee Novick, MD · Answer

At least from the photos, the use of a robust HA volumizing filler for the cheeks would create a more oval, heart-shaped face, as well as diminish smile lines and to some extent the incipient marionette lines. A robust HA lifting filler would straighten the angles of the mouth and very likely secondarily improve the jawline jowls. More directly, a robust HA lifting filler can be used directly along the jawline to straighten and contour it and address the sagging jowl directly. In the hands of an experienced injector, all of the forgoing can be achieved, with immediate results, in less than thirty minutes. You would be wise to make sure to consult a board certified cosmetic dermatologist and best of luck.

Randal Haworth, MD, FACS · Answer

Jowls are a natural part of the aging process, and they occur when the skin and underlying tissue in the lower face begin to sag. While fillers can be used to add volume to the cheeks and other areas of the face, they may not be the best option for addressing jowls.

The best option would be a facelift, which involves tightening the skin and underlying tissues in the lower face to create a more youthful appearance. Here is the link redirecting you to photos of one of my patient who got her facelift in her mid-30’.

It's important to schedule a consultation with a board-certified facial plastic surgeon who can evaluate your individual situation and recommend the most appropriate course of treatment based on your goals, concerns, and medical history. They can help you understand the potential benefits and risks of different options and help you make an informed decision about the best course of action for you.

I hope this helps,
best of luck !

Robinson Facial Plastic Surgery - Alpharetta · Answer

Hi there! Thank you for your question. Marionettes and/or jowls can be very frustrating for the patient ( I know because I have them), and tricky for the injector. They are one of the trickier areas to treat because they really almost require a full face approach in order to correct or minimize them. This is because the volume loss in the mid face is causing the lower face to droop down, therefore, that needs to be addressed first to get to the root of the issue. In your case, you can see that you have mid face volume loss because your lower eyelid/cheek junction is hollowing out and your cheeks are flattening. This is causing you to develop nasolabial folds, or smile lines, and jowls/marionettes. 
I would treat this by first adding filler to the cheeks and lower eyelids. You can probably do this with 2-3 syringes of filler. This will sometimes help pull the jowls up a bit, not requiring as much in that particular area. Once the midface is taken care of, you can move down to the jowls and fill the marionettes with a soft, flexible filler. This combo would give you a more youthful and refreshed look, without being overdone. 
Lastly, know that whenever looking down, you will have skin that comes forward, creating jowls. If you are going to judge this area, do so while you are looking straight ahead. I hope this information helps you and wish you the best of luck.

Camille Cash, MD · Answer

From your photos it appears you would have the best result from a combination of treatments.  Fillers can be used to help soften the appearance of the jowls.  Other treatments such as FaceTite and Morpheus8 can tighten skin as well as improve overall skin tone and texture.  See a board certified plastic surgeon near you to learn more.