Neck Lift & Sagging Jowls Corrected: Comprehensive Skin Rejuvenation

Hello everybody again. This is Dr. Sage from Dermis Skin Institute, and today we’re going to be talking a little bit about jowls and what to do about them. So what are jowls? Jowls are really the accumulation of skin and fat, really sort of in this area here. And if you can pinch more than a couple of centimeters, they really start becoming an issue for most patients and really something that needs to be done about them. So the question really is what do we do? How do we get them and how do we actually treat them? So before we get into it, we have to just understand why they happen in the first place, what leads to them sort of drooping and accumulating in this such a manner. And one of the key things is understanding that it doesn’t really happen in one process, it’s multiple processes.

Understanding of it really led us to develop our own approach and a treatment that’s only available at the Derma Skin Institute called the Five Dimension Lift. And it’s really based on the five dimensions of aging that we see. So in our skin, there’s what I call five different dimensions where we’re going to all experience three different things, and that’s descent, degradation, and deflation. So first one, degradation. So the collagen, the bone, the muscle, the fat, all of that is going to experience degradation. It’s all going to depreciate, deflation, and also descent because of gravity. So how do we address it? Well, really, I mean we have to look at all of those five dimensions and really find out how we can sort of do that. So the first dimension is bone. So if we’re starting to lose a lot of bone here, guess what? You’re going to lose the support.

So there are ways to enhance the bone, both here and here. And if we’re losing the amount of fluid through the air and bone through there, we really need to strut that up and make it a more firm base and a good support so that we can really drape that skin on top and really help lift it. Now, there are many ways to do that from lasers to fillers to energy devices to surgery. And so the question really becomes is how do I pick the best, the most efficient one that will get me as far as possible to having that really nice defined jawline? Because really that’s what we’re asking about is we want that nice defined chiseled jawline that comes with youth. And as we get on with father time, we start to lose that and most of us subconsciously know that, and we want to naturally and obviously want to get back there as much as we possibly can in the best and most natural way possible.

So the key differentiator for me really is looking at one of two things, and that is either surgical approach or a non-surgical approach. Now, one way to differentiate whether you need one or the other is how much skin you can pull. So if you can grab your skin and you can pull more than two inches, I think it’s definitely time to at least explore surgery. Now the other way to think about it is if you are at a point where you do need surgery, you’re probably going to need some of the other treatments like skin tightening, like volumization, like bridging those struts anyway. So whether you pick surgery first or you want to do a mini non-surgical lift or a maximum five dimension surgical lift, non-surgical lift that we have at our clinic is really up to you. And depending on how much diet and time you have, the budget and also scarring with most facial surgeries, even if they call ’em a mini surgery, you’re going to have a pretty significant scar so that they can actually pull back and remove that tissue.

They try to do their best to hide them. And in many patients, the scars are close to being invisible. But again, for many of our patients that seek us, they really come to us because we’re the experts in non-invasive technologies. And we have a vast array of things that we can use from energies to radiofrequency, to devices, to fillers, to other techniques to really help lift your skin. So the question then really becomes is what type of procedure should we be looking at as the first thing, or should we be combining them with several other procedures to really get the best lift? So for me right now, I think if we look at the literature, we look at what the devices are available, what is the best thing that was given us, the most skin tightening, the most lift, that’s nonsurgical, noninvasive without a scar, I think nothing beats accutight right now.

There are other devices like radiofrequency, microneedling devices like Morpheus, profound, for example, is another good option. But when you compare all the devices across the board and see which one has the most lift on its own, Accu tight, facet tight are generally the best options, I feel both accutight and face tight are more or less the same device. You’re going to get the same type of lift. It’s just really the size of the actual probe that goes underneath and delivers the energy in a way, in a very similar way that’s the same temperature. So we’re going to have the same clinical results just with Accutight. We’re able to target other areas like eyelids, the sub malar, fat nasal lial folds. That makes it all harder to do with face type because it’s a bigger, longer probe than the acuate. So if we’re looking at it, what does it do?

Really, like I said, it’s a probe that goes underneath your skin and is able to check the temperature on a very, very controlled level to a point where we can be very precise to 0.5 of a degree. The machine is checking it many, many, many times, hundreds of times a second to ensure that we’re getting a proper temperature control. And if it exceeds the threshold or it rises too fast, it’s going to control it so that we really, really minimize the risk of burning. So again, for that reason, I think if we’re looking at any one device to really lift, tighten, melt some of the fat that’s under there, Accu is going to be our best number one decision. Now, often we do pair it with a radio frequency microneedling, like for example, the Morpheus eight, the genius phony, sometimes even profound. But it’s knowing and understanding that really the heavy lifting is going to be done by Accutight, and then that finalizing on the cake is really going to be done by something like Morpheus.

Another thing to consider would be fillers. So once we get that, I like to first see my patients do the accu tight, see how much pulling, maybe Morpheus eight with it as well see how much tightening we can get. And then once we get there, I generally assess for fillers. So by doing jawline or chin fillers, we can really get that proper projection and really accentuate and give you that chiseled jawline associated with youth that many of our patients desire. But really, like I said, I like to start with Accu type first, see how far we get. And then that way, even if we need fillers, we generally need less fillers, less volumization, and our critical goal is really to avoid that unnatural overfilled look that results when providers and other doctors and other physicians really only address the one issue and the one dimension in aging.

And it leads to this overfilled or pillow face look that we really generally try to avoid. The best, I think, is really to come in for a consultation. There are many strategies and many other treatments that can be quite complimentary. For example, if you have a lot of sun damage, your skin is very loose, or you have a lot of pigmentation on your face, sometimes we do combine it with carbon dioxide or CO2 laser. That can also give a lot of lift, a lot of volumization that can help restore that structure to the face that we miss with aging. Anyways, stay tuned. Stay tuned for our next conversations. Hopefully that was informative and we hope to see you soon. Stay tuned for next one.