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Sagging jowls — surgery or non-invasive treatments?

Posted:2:26 p.m. Friday, April 18, 2014

By Anita Mandal, M.D.

Question: I’ve noticed my jowls starting to sag. Can the loose tissue be improved without having a facelift?

Answer: The choice of treatment for sagging jowls depends on the cause of jowling as well as the degree of sagging. Sagging of the lower face, particularly the jowls, can be due to one or more of the following factors:

• Loss of soft tissue elasticity
• Downward pull of gravity
• Volume loss in the cheek and jaw region

When facial sag is due to the pull of gravity and poor tissue elasticity, tightening and direct lifting of the tissues is the best option. This can be achieved with non-invasive Ultherapy™ treatments in mild to moderate cases. A facelift is performed for more significant sagging.
In other patients, volume loss of fat and bone along the jawline or cheek areas are a commonly overlooked cause of facial sagging. In such cases, a facelift may not help the sagging. Think of the aging face as a balloon that deflates with time. Treatment is by restoration of lost volume using either facial implants or, more commonly, injectable fillers. Temporary fillers such as Voluma™, Juvederm™, Radiesse™ and Sculptra™, or long-term fillers like Bellafill® can be injected into the deflated areas.
Many patients over age 50 require both lifting and filling to address tissue sag. Careful consultation with your Facial Plastic Surgeon — one who is especially skilled in facelift surgery, Ultherapy and injectable fillers — is the first step.

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