Comments Off on Jowls

Today’s question:

I have had uneven sagging jowls my whole life. Is there something that can help me out?

-Casey P.


Hello Casey,

Young people tend to have a lot of volume on the top half of their face and less volume at the bottom.  Think of an egg on its apex.  As we age, however, a lot of the volume that was previously in our upper and midface begins to fall to our lower face and our face becomes bottom heavy.  We develop jowls and marionette lines. Sometimes, an individual may have this appearance at a young age which seems to be the case with you, Casey, since you are asking the question.

The good news is that our doctors and nurses and SDBotox can likely help you out. Consultations are free and we invite you to come in so we can assess your face and put together a more complete plan. Having not seen you, however, I can give you a general idea about we typically treat jowls and marionette lines.

First, we would likely recommend adding volume to the midface, specifically the front and side cheek. We would achieve this with strategically placed dermal filler. This will pull up/elevate the sagging tissue creating the jowls and marrionette lines. It will also restore the top heavy appearance of the youthful face. Remember the egg on its apex?  Depending on the dermal filler we choose, the product typically lasts 1-2 years and costs range from $500-$900.

Next, we would likely inject Kybella into the jowls. Kybella is the trade name for Deoxycolic Acid. It permanently destroys fat cells and tightens overlying skin, basically the opposite as a dermal filler. It is FDA approved for submental fat, commonly called a double chin, but we have seen success in jowl reduction. Patients typically require 3 procedures 4 weeks apart. Results are permanent and cost typically run around $500/treatment ($1500 total).

Finally, following the last Kybella treatment we would re-asses your face and determine if you would benefit from dermal filler in the Marrionete lines themselves. We are typically prudent with adding volume in this area because, again, we typically like to add volume to top and middle of the face and decrease volume to the lower face recreating the youthful egg on its apex. Marrionette lines, however, can be injected with a small volume of dermal filler to decrease their appearance. We may even put a small amount of dermal filler in the Marrionette lines and the rest of the product in the cheeks for further enhancement. Depending on the dermal filler we choose, the product typically lasts 1-2 years and costs range from $500-$900.

SDBotox Prime: $475

We hope this was helpful. Feel free to make a free consultation with SDBotox at 844-732-6869 or 844-SDBotox. Have a beautiful day

-Dr. Roher, M.D.