A facelift, jowl lift, or buccal fat removal are a few ways to get rid of jowls. These pesky protrusions occur with age due to lax skin or lax muscle. The term jowls is sort of a euphemistic term that doesn’t have an exact definition. They are actually tissue that sits behind the fold that, over time, sags down, sometimes below the jaw bone.
What’s the best treatment for sagging jowls?
The best treatment for sagging jowls depends on the severity and the presence of buccal fat vs. just sagging tissue. In a young person who’s got a little jowl with tissue that is relatively tight, I do a buccal fat extraction. It’s a beautiful procedure done under local anesthesia, where we numb inside their mouth and make a little incision to find the buccal fat pad. By letting it prolapse into the mouth, we cauterize it and remove it, then close it with a couple of dissolving sutures..
In that subset of people who only need buccal fat removal, lifting of the tissue is unnecessary. However, for many people, the jowl is a combination of sagging skin and buccal fat. For those patients, I prescribe some form of lifting. When we lift, we lift up the fat pads and place them in a new position. As I like to tell patients, it’s like an underwire bra, to lift their facial fat.
All faces are different, and it’s important to have a surgeon who can perform the right surgery for the right patient. What’s wonderful is that when I do a traditional lift, a face, neck and jowl lift that lifts everything up, it makes the jawline look better and makes the face top heavy as opposed to bottom heavy. A young face is an upside down triangle which is wider at the top than bottom, but as we age the triangle becomes upright with more heaviness and volume at the bottom. A lift re-balances that.
When our faces are shaped like a triangle with jowls we tend to look like a hound dog, but when we lift that up, we reverse time. However, some patients are not physically or financially ready for a lift surgery, so in those patients, I often perform a thread lift. It doesn’t work as well, and it doesn’t last as long, but it does produce results by repositioning the soft tissues and fat.
I address each patient individually, so what’s ideal for one patient is not for another. I use small procedures for small problems, but bigger procedures for big problems. What I like to do is have the patient come in for a consultation so I can assess their face and come up with a treatment plan that we both agree with.
It’s really important to go to a surgeon that offers a full gamut of treatment options. I’ll occasionally even use a little filler around the jowls to camouflage the marionette lines which in turn improves the appearance of the jowls. So look for a surgeon with a complete treatment arsenal that includes options such as fillers, thread lifts, and surgical lifts.
Do you have questions? Call or email me anytime you want. I’d like to see you and help you.
Email Dr. Sykes at [email protected]
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About Dr. Jonathan Sykes
Dr. Jonathan Sykes is a world-famous expert plastic surgeon who performs all cosmetic and functional plastic surgery procedures on the face and neck. He is a past president of The American Academy of Facial Plastic and Reconstructive Surgery, and served on their Board of Directors for over 10 years. He is also a Professor Emeritus in Facial Plastic Surgery from UC Davis Medical Center, and the former Director of Facial Plastic Surgery at that institution.
He is known as the expert’s expert, and is often called to consult and advise other plastic surgeons in both Northern California and Beverly Hills. He has a special interest in eyelid and browlift surgery, facial rejuvenation surgery including facelifts, and rhinoplasty. He also has a particular interest in facial feminization surgery. Have questions? Email Dr.Sykes at: [email protected]