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Sagging jowls: Gravity vs. volume loss

Posted: 11:46 a.m. Saturday, July 25, 2015

By Anita Mandal, M.D.
Question: I have sagging jowls. One doctor advised a facelift or Ultherapy if I didn’t want surgery. Another said filling the cheeks would lift my jowls. Which option will give the best results?

Answer: Sagging of the jowls or tissue along the jawline can be due to collagen loss, allowing the downward pull of gravity to take over. A commonly overlooked cause is volume loss in the mid-face cheek area due to fat and bone loss with age. With progression of aging, a combination of both volume loss and gravity causes sagging.

When sagging jowls improve with filling of the upper cheeks, the cause is mainly mid-facial volume loss. When cheek filling does not improve sag, then gravity and collagen loss or a combination of gravity and mid-facial fat/bone loss are the cause.

Mild to moderate jowls due to volume loss can be effectively treated with injectable fillers like Bellafil or Sculptra. More moderate jowls must additionally be lifted non-surgically with Infini or Ulthera or surgically with a facelift. Severe sag is often due to a combination of volume loss and gravitational forces, requiring both mid-facial volumization as well as a lifting procedure.

Careful consultation with a Board certified Facial Plastic Surgeon to accurately identify the causes in facial sagging in order to provide the most effective treatment is the first step.

It is a misconception to think you should only seek a surgeon for surgery. Facial Plastic Surgeons have in-depth knowledge of facial anatomy and expertise in both non-surgical and surgical facial aesthetic treatments. An alarmingly growing number of doctors, not board certified in plastic surgery, are performing cosmetic treatments. Each time you have a non-surgical cosmetic procedure by a less qualified doctor, you increase your risk of complications and poorer results. When it comes to your face, why would you consider less than a Board Certified Facial Plastic Surgeon? Go to www.abfprs.org to verify that your doctor is board certified in Facial Plastic Surgery.

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