From Sagging to Sculpted: 5 Jaw-Dropping Jowl Cases

This patient came to our practice at age 59 with the goal of looking more youthful when she turned 60. Most surgeons would rely on a standalone face and neck lift, overlooking other procedures that would take the results to another level. I created a surgical plan that included deep plane techniques for the face and neck, deep fractional carbon dioxide laser resurfacing of the entire face (including the eyelids), and rhinoplasty.

Plastic surgeons often don’t appreciate how improving the appearance of the nose—which gets larger with age—creates a harmonious result. Without rhinoplasty, I don’t think she would’ve looked as young following the surgery. The key to this case is combining the deep plane techniques with the laser and rhinoplasty for optimal effect in just the right amounts and for just the right candidate. As in many of our cases, what stands out about this patient is that she has a dramatic transformation, but she doesn’t look like she had a lot of plastic surgery. She just looks great. 

Improving the shape of the jawline for this beautiful 52-year-old mom was only one piece of the facial rejuvenation plan I created after our initial consultation. I believe the average plastic surgeon would not have appreciated the changes in skin texture around the eyelids, an underdeveloped lower jaw, and the loss of skin elasticity in her lower neck.

My plan included a deep plane face and neck lift, chin augmentation, upper and lower blepharoplasty, and 2 rounds of fractional carbon laser resurfacing. In the “after” photo, you can see her cheeks are much fuller and rounder, and the hollowing under her eyes is smoother. Additionally, I minimized her nasolabial folds, and you can see that her jawline is much more ideally shaped.

I think this case is a great example of a beautiful, natural-appearing result. The patient was transformed and looked probably 15 years younger than before surgery. This patient lived in the Los Angeles area at the time but later moved to the northwest. She’s been so pleased with her surgery that she has continued to fly down to see me for additional procedures and operations ever since we performed this operation.

This patient has a keen, professional eye for beauty and natural appearances, so I was pleased she chose me as her plastic surgeon. What stood out about this patient is the extreme laxity of neck skin, with folds that are perpendicular to the folds on the face. This required an approach that addressed multiple vectors with a deep plane facelift and neck lift, elevating the deep layers of fat and muscle to a more youthful position without creating an unnatural windswept appearance.

Her lower eyelids presented another challenge. Many surgeons might have performed lower blepharoplasty. I opted instead to use a fractional carbon dioxide laser superficially on the lower eyelids twice. Many doctors don’t have access to a fractional carbon dioxide laser, which I believe is an extremely useful tool for creating substantial improvements in areas where a facelift or neck lift won’t help. I also performed laser skin resurfacing to almost completely eliminate wrinkles and sun spots on her central face.

I love getting dramatic improvements for patients such as this and take great pride in shaving decades from their appearance without the results looking unnatural.

My patient featured here is a discerning 46-year-old professional with many connections in the healthcare industry, so I was particularly pleased she chose me to perform her cosmetic surgery. I consider it an honor that she found my work and reputation to be the best for her needs. After evaluating her skin quality, bone structure, and facial type, I decided to combine a deep plane facelift and neck lift with chin augmentation and upper eyelid surgery.  

Augmenting her chin created the ideal structure over which we could drape her skin and soft tissues for optimal facial proportions. Upper eyelid surgery removed folds of skin and exposed her beautiful blue eyes that now sparkle. The deep plane face and neck lift elevated underlying fat and muscle into a more youthful position, resulting in her appearing 10 to 15 years younger and even more beautiful than she was before surgery.