Explore Plastic Surgery

One of the earliest signs of facial aging is the development of jowls or jowling. The jowls are areas of skin and fat that have fallen from the side of the face to hang along or below the jawline. As we age, these areas tend to become more noticeable as the sag worsens. The once straight jawline of youth is gradually replaced by the saggy full jowls of the aging face. Why this occurs is the age-old phenomenon of time and gravity, weakening the attachments of the skin to the underlying muscle so that a tight bond between the two no longer exists.
I see many patients who are bothered by jowling, including younger patients who often see this as one of the first signs of real aging. There are numerous options to treat the jowls, both surgical and non-surgical, with varying degrees of effectiveness. The most effective methods, to no surprise, are surgical and include facelifts and liposuction. A facelift in its fullest extent is a jowl-neck lift. In its more limited form, it is primarily a jowl lift. It works by pulling skin and deeper tissues up and back, eliminating the jowls by pulling loose tissue above the jawline again. The loose jowl tissue is simply repositioned and not removed. More minor procedures that have recently gained popularity, which aims to do the same thing, are the Threadlifts or Featherlifts. In this simple procedure, barned sutures are passed deep into the cheek and facial tissue above the jowl area and cinched up from above. For very minor degress of jowling, this has some benefit but is not effective enough with large amounts of jowling and the long-term results with these procedures is suspect. Actually removing jowl fat can be done with liposuction, reducing their size. This can be done alone or in conjunction with some form of a facelift. When performed alone, liposuction of the jowls must be done very carefully and conservatively, lest you get irregularities that are apparent in the overlying skin. When done with a facelift, the lifting and tightening of the skin usually eliminates this concern.
Non-surgical options include skin tightening by heat-generating devices and LipoDissolve. neither approach treats both of the jowl issues, skin and fat, and therefore they are usually less effective than surgery. Heating the underside of the skin through a series of treatments can cause a tightening effect. Devices such as Thermage or SkinTyte do it differently but the objective is the same, heat up and the skin on its underside and cause it to tighten. The long-term results of this procedure appear to be short-lived and that is why I perform them in conjunction with other procedures rather than as a stand alone technique. LipoDissolve treats the jowls by fat-dissolving injections done as a series. As the fat dissolves, the jowl is reduced in size. In my experience, it is just as effective as liposuction, albeit a lot slower. When performing non-surgical jowl reduction, I like the combination of LipoDissolve and Skin Tyte. That combination seems be particularly effective as both components of the problem, skin and fat, are addressed. They are also great touch-up procedures to do after a facelift when a little rebound relaxation in the jowl area occurs.
The jowsl can be treated by numerous surgical and non-surgical methods. Limited and full facelifts produce the best and most long-lasting results and should be the first choice when moderate to severe jowling is present. In more minor jowling, LipoDissolve and Skin Tyte work well if the patient can tolerate a slower speed of noticeable improvement.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Spring is finally here – and this is the time of year when one starts looking in the mirror and seeing dull, dry winter-time skin. I’m often asked which skin care treatments are most effective and how patients can best maintain their surgical results. While the answers aren’t the same for everyone, I can tell you there are three truly effective things that you can do to improve your skin’s condition – and doing these things with the start of each new season can really establish a routine easily.

Microdermabrasion. This is easy; effective – and is affordable to do on a regular basis. Honestly, this is the most consistent method to maintain skin that is in good condition – without muss or fuss.

SkinTyte™ Laser Treatments. I am seeing very good results with these treatments, and they have proven to be even more effective when combined with an exfoliative treatment (such as Microdermabrasion). SkinTyte™ is non-invasive, so it’s also easy to do on the way home from work and does not require any recovery time.

MicroLaser Peels™ These are far and away the fastest way to better skin. MicroLaser Peels™ (also called the ‘Weekend Peel’) are the treatment I most often recommend to my own family as a quarterly ‘maintenance’ treatment. Laser peeling has changed drastically since the days when carbon-dioxide lasers were all that were available to us, and we’re now able to do light to medium to deeper peels in the office that produce only a few days of redness and flaking skin – and can be repeated on a monthly basis- rather than requiring weeks of recovery and the expense of surgery. We can be as aggressive or as conservative with each peel as a patient wants, and can base each peel on your needs at the time and any activities you have planned.

This new season is the ideal time to re-evaluate your skin care routine. The above three treatment options, combined with a good skin care program of topical solutions, can being on the sunshine in your own skin!