Jowls and Sag: Injecting Dermal Filler to Improve the Lower Face

Before and after 1 treatment of dermal filler for jawline, sagging, jowls and lower face ageing

Injecting dermal filler  to improve the lower third of the face with regards to improving jowls and sagging/drooping is a really important area. It is so misunderstood by patients and sometimes doctors.

As the face ages, there is a loss of volume, of the bones of the face and the soft tissue. The cheeks and mid face dissolve,  the mandible and chin also change structure. What was held up, now falls down creating jowls and an aged appearance of the jawline and neck.

Patients need to be re-volumised. Doctors recently decided to look at what happened with ageing. This only happened in my lifetime btw, which I find quite a disgrace. Surgeons, until the explosion in the late 90s and naughties, of the non-surgical cosmetic industry, were the ones treating ageing. My guess is that surgeons of the past, with their hammers, thought everything was a nail and focused 100% on what they saw as “excess skin”, and cutting it and lifting it, without assessing the details of the cause and signs of ageing.

Fortunately there is now only a small percent of patients and surgeons who are stuck in this unsophisticated mindset.

Interestingly I still get patients on occasion who say “I’m not going to get filler, I’m just going to wait and have a facelift.

This is like someone needing to get new shoes for an event but saying, “I’ll just wait and buy a hat”. Ah NO. If you need shoes, you need shoes, if you need a hat, you need a hat. If you need shoes and you buy a hat, you will be barefoot at your event. If you need volume and you buy a facelift, you may look sagless yet old and unnatural, with a stretched little bird face.

Don’t think that I have anything against surgery (LOL I’ve had more cosmetic surgery than anyone I know, and I hang out with some true plastic positives!). Also, I’m super-excited at the thought of the neck lift I will one day have. So this is not an anti surgery rant, it is just a “choose the right tool for the problem” rant.

OK, back to lower face injecting.

When a patient comes in and points out their marionettes, jowls, and basically the problems in their lower third of their face (sometimes they also include the mid face) I tell them how this has occurred see above. To treat the lower face problem, we really need to treat the whole face, in particular, the cheeks, as that is a large part of the lower face issue. So many times after I have said that, patients will say “but I don’t want my cheeks injected” So I try to reexplain the ageing process, so that they can understand why we have to inject where we do. Some patients will take my advice, and some patients will still get me to create an inferior result by injecting only the lower face, and not actually treating the problem. This is similar to when a patient wants their nasolabial folds injected. Often this is due to loss of volume in the cheeks, so injecting the cheeks is really important to treat the cause and to make the results appear natural, BUT the patient will say no, just inject the nasolabial folds

The before and after image above  is an awesome case where I was given creative control ( ie I didn’t have to contend with “I only want the injections in my jowls”). I injected this patient on one occasion, which took about 30 minutes in total. We injected 8 mls, into her mid face and lower face. My aim was to improve the appearance of the jowls, but to also just improve her whole look. I will write more about this case in detail as it was so interesting from an emotional perspective as well as a physical.

Please see another case of lower face dermal filler injecting for lift