How do I remove my jowls without affecting or losing my round cheekbones? Thank you!

The jowls and cheekbones are 2 separate areas of the face.

The jowls refer to the drooping / sagging of the skin and cheek (buccal) fat around the lower face, causing a disruption in the otherwise smooth jawline.

This can be due to a combination of factors like:

• loss of **skin elasticity
  **
• loss of volume due to ageing or sudden weight loss
• bony resorption ( reduced bone volume due to ageing)
• and lastly, laxity of the superficial musculoaponeurotic system (SMAS)

The cheekbones aka Malar bones are bony landmarks on the face and this is usually genetically predetermined. Certain ethnic groups are well endowed with more prominent cheekbones. From the photo you posted, there appears to be some sagging in both the middle and lower face, with some jowling seen and prominent Nasolabial folds. (NLF)

Jowl Treatments

Back to your question about jowl treatments, depending on the severity of the jowls and the likely cause, your doctor may recommend a few procedures. I tend to treat both the NLF and jowls together using a combination of treatments such as.

• Skin tightening with an Energy based device
  I would recommend HIFU (high intensity focused ultrasound) because it is non invasive, low downtime and skin-type neutral (can be performed in light or dark skinned individuals) HIFU can also address laxity in the SMAS layer and subcutaneous layer. However, if done incorrectly or excessively the energy from the HIFU can cause fat atropy especially in the submalar (below the cheekbones) and loss of the precious "apple cheeks"

• **Filler injection for volume replacement in the sub-malar space( below the cheekbones) and on the cheekbones for lifting effect.

  **

• I recommend Juvederm Voluma for it's longevity up to 16 months.

• Thread rejuvenation with bio-absorbable threads
  This repositions the fat pads, and depending on the material used ( PDO/ PCLA), can confer other benefits in terms of longevity of the treatment and bio-stimulation. This method will not affect the cheekbones at all.

Hope this answers your question.

Regards
Dr Mark Lim

The jowls and cheekbones are 2 separate areas of the face.

The jowls refer to the drooping / sagging of the skin and cheek (buccal) fat around the lower face, causing a disruption in the otherwise smooth jawline.

This can be due to a combination of factors like:

• loss of **skin elasticity
  **
• loss of volume due to ageing or sudden weight loss
• bony resorption ( reduced bone volume due to ageing)
• and lastly, laxity of the superficial musculoaponeurotic system (SMAS)

The cheekbones aka Malar bones are bony landmarks on the face and this is usually genetically predetermined. Certain ethnic groups are well endowed with more prominent cheekbones. From the photo you posted, there appears to be some sagging in both the middle and lower face, with some jowling seen and prominent Nasolabial folds. (NLF)

Jowl Treatments

Back to your question about jowl treatments, depending on the severity of the jowls and the likely cause, your doctor may recommend a few procedures. I tend to treat both the NLF and jowls together using a combination of treatments such as.

• Skin tightening with an Energy based device
  I would recommend HIFU (high intensity focused ultrasound) because it is non invasive, low downtime and skin-type neutral (can be performed in light or dark skinned individuals) HIFU can also address laxity in the SMAS layer and subcutaneous layer. However, if done incorrectly or excessively the energy from the HIFU can cause fat atropy especially in the submalar (below the cheekbones) and loss of the precious "apple cheeks"

• **Filler injection for volume replacement in the sub-malar space( below the cheekbones) and on the cheekbones for lifting effect.

  **

• I recommend Juvederm Voluma for it's longevity up to 16 months.

• Thread rejuvenation with bio-absorbable threads
  This repositions the fat pads, and depending on the material used ( PDO/ PCLA), can confer other benefits in terms of longevity of the treatment and bio-stimulation. This method will not affect the cheekbones at all.

Hope this answers your question.

Regards
Dr Mark Lim