I hate my jowls!
This is probably the most common complaint I hear in my office. The treatment of jawline skin laxity has evolved significantly over the past few years. In the past, the only option was a surgical one. Most people underwent a neck lift plus or minus a facelift to treat lax skin in the lower face. Surgery is still the best treatment option for some people, but there is a subset of people in their late 30s to late 40s who are not quite ready for surgery, but are interested in ways to treat the neck and lower face with minimally invasive methods. Like most problems in aesthetic medicine there is no magic bullet, but rather several treatment modalities, which can work together to improve the area of concern.
Before getting into treatment options, let's discuss the cause of skin laxity and the appearance of jowls in the lower face. Support for the jawline and lower face is comprised of bone, muscle, and of course the skin which contains collagen and elastin. As we age our bones reabsorb and shrink in volume, and the bones of the face are no exception. It's not your imagination if you're noticing that your chin is more recessed than it used to be, and loss of bone in the mandible is the largest contributor to this phenomenon. The next change that some people find surprising is the tightening and contraction of the platysma muscle with aging pulls downward on the skin of the lower face. Finally, the loss of collagen and elastin in the skin affects its thickness, causing it to appear as though it is draped over the lower face, almost hiding the jaw bone
The nonsurgical treatment of this complex issue typically involves injection of filler along the jawline and chin as well as Botox to the platysma and other muscles to relax the downward pull. In addition, a skin tightening treatment such as Softwave can help tighten the area. Using multiple treatment modalities and some periodic maintenance will usually allow us to put off surgery for another 5-10 years.