I just turned 58. Is there a non surgical way to lighten up saggy jowls?
How do I find a qualified doctor or whoever I need to see? Thank you, Rachel
Thank you for your question!
You just turned 58 and you want to address you jowls and of course you want a non-surgical
option. So this is a discussion that I have in my practice every day and unfortunately,
there is a lot of misinformation out there that is promoted by people who market various
devices in doing procedures that typically require surgery without surgery. But before
we go into that, let's just discuss a little bit about why at this stage of your life you
have jowls.
Well, a few years ago, I wrote a book called "The Fine Art of Looking Younger" and it was
based on the idea that I wanted to share with everyone who reads the book as I do with my
patients everyday and explain that facial aging is two processes: one is volume loss.
That is bone, muscle, fat, skin and soft tissue. Things get smaller and there's less volume.
You look at a younger person, there's a lot of fullness to their face. Then there is descent
and sagging. Now this is probably what you're manifesting with the jowls. Now the sagging
has two levels when you look at what is obvious. When the face sags, there is the descent of
the skin and then there's the descent on the underlying support structure called the SMAS.
The SMAS is commonly referred to the muscle and it stands for superficial Musculoaponeurotic
system and it is an extension of the muscle called the platysmal muscle. So when you have
jowls, they typically represent sagging and an area of fat that is below your jawline
which diminished the nice shape of the jawline.
Now a typical patient 15 to 20 years ago would have accepted and realized that in order to
solve this issue, some type of face lifting or face and neck lifting procedure needs to
be undertaken. Then a proliferation of laser devices and heating devices came around from
my perspective, misrepresent that the effects of those devices can be the same as surgical
procedures. In the 90s, there was a lot of excitement about the CO2 laser and the CO2
laser was going to make facelifts obsolete. And then in the past decade or so, there's
been several equipment manufacturers that essentially through combination of selective
language and creative photography, make it appear that the results are equivalent to
surgical procedures. In my practice, practically every day, we see people who have had some
type of thermal device and have been basically had less money because they spent a lot of
money in doing this procedure and to not seeing the result.
In addition, it has been my observation that the newer thermal devices actually heat up
the skin so aggressively actually reducing the quality of the skin. There is a very important
layer of the skin that is very important for a youthful appearance. The concept of heating
up the skin to the point that it contracts becomes tighter, unfortunately, trades off
trauma and damage to the blood supply and the fat. So as a surgeon, I see this and of
course, I feel bad for people who have bought into this. And it is not their fault. They
actually see these things promoted on TV shows and it seems like great authorities are representing
them and being significant.
The principles remain the same. If your face is sagging and you have jowls, you have different
options on different kinds of surgical procedures which can be minimally invasive, limited or
more extensive face and neck lifting procedures. For some people, having just a little bit
of a jowl only requires liposculpture or maybe a little bit of neck tightening. That would
be the least aggressive procedure. And for most people, anybody with jowls, it is some
type of face lifting or face and neck lifting procedure.
So before you invest your money in doing a nonsurgical solution for jowls, do your research
and look at actual results and you'll probably realize that avoiding surgery all together
is not necessarily a smart way to go. Now, I'm not saying that nonsurgical options cannot
help improve the appearance of the jowls. For example, some patients of mine come in
and plan their face and neck lift later about 1 or 2 years but the short term if they have
important events coming up. So we can soften the appearance of the jowls by strategic placement
of filler such as Radiesse. As a described, volume loss is a factor in facial aging and
so with limited correction on those areas of volume loss, particularly along the area
of the jawline in an area called the mandibular notch and the mesolabial fold, you can soften
that appearance of the roundness of the jowl and make the jawline look a little bit better.
So I think at this point, I recommend that you meet with cosmetic surgeons and I say
specifically surgeons because unlike non-surgeons, surgeons are able to do everything. So if
they have devices as well as injectables, they can offer that as a way to help you along
the path or be very definitive about the necessity of a surgical procedure. So meet with doctors,
look at their results, think of how these procedures are done.
In our practice, we do all our face and neck lifting procedure with a quick recovery concept
where we do everything under local anesthesia with LITE™ IV sedation. Our patients recover
quickly. The hesitation about pursuing face and neck lifting surgery has to do mostly
about anesthesia and the recovery time. Well, in the past 20 years, I have developed a way
to minimize that while still doing a proper face and neck lift. Not shortcut procedures.
We learned in the mid 90s that shortcut procedures don't get very good long term results. So
again, meet with cosmetic surgeons whoever you are comfortable and feel like this something
that you have realistic objective that you are able to accomplish and move forward with
the best solution.
So I hope that was helpful, I wish you the best of luck and thank you for your question!