Q: I have been developing droopy jowls over the past few years and it is getting worse. I am 50 years and I don’t want a facelift or surgery. Is there anything that may help them go away that doesn’t involve any cutting and scars? I have read about some fat dissolving injections which they say can make jowls get better. Is this true?
A: The development of jowls or jowling will occur in everyone eventually. These classic aging signs are when the skin and fat that used to be up on the side of the face comes sliding down due to time, gravity, and weakening of the skin’s attachments. There is no question that the preferred as well as superb treatment for isolated jowling is some form of a facelift. If jowling and not the neck is the main issue, then a more limited type of facelift will work quite well. These smaller facelifts (jowl lifts or tuckups) go by many different names, most popularly known as a MAC Lift or a short scar facelift. Regardless of the branded name, they are all essentially the same type of limited facelift operation.
Short of surgery, fat dissolving injections have been used for mild jowling. Known as Lipodissolve injections, these chemical concoctions do have the ability to break down small areas of fat and tighten just a little bit of skin. I have used them very rarely in the jowl area but, in the handful of cases that I have done, there was a definite amount of improvement and several of those patients were absolutely thrilled. The key is in patient selection. They must not have too much loose skin or too much jowling or these injections will have no benefit.
There are also other device-driven methods of jowl tightening such as Thermage, Skin Tyte and others. The concept is to treat the deeper skin and underlying tissues with heat, ultrasound or radiofrequency energy to create the tightening. These device approaches to jowling would be more mainstream and accepted as opposed to Lipodissolve injections.
Dr. Barry Eppley