"Jowl Trowel" Treatment of Adjacent Tissues to Correct Jowls

One of the most challenging problems in aesthetic surgery has been how to treat the development of lower face jowls. There has been no successful localised surgery invented to directly address this issue. Face lifting attempts to pull the jowl outwards towards the lower ear but this does result in a rather stretched and anatomically incorrect appearance.




It should be appreciated that in the lower third of the face there is a volumetric loss of bone, muscle, fat and skin. This creates the so called  pre-jowl sulcus which may by subtraction represent the impression of a neighbouring and detested jowl as seen in this ageing rock icon.



However are we seeing true jowls or just deficient tissues adjacent to the jowl? Certainly it is logical to re-volumise this area with biological fillers-what I have termed "jowl trowelling".




Below is a commercial photo of successful treatment with a filler of the pre-jowl sulcus-jowl gone!

Generous Warm Lips

 

The lower third of the face is defined as the area immediately below the nose to the base of the chin.

In this region treating the lips in a manner that restores youthful definition and volume is the key target that can provide standout results.

The loss of volume and contour with lip ageing can impart an impression of unintended meanness or anger.
However restoration of lip volume and contour can reverse this tendency to convey a sense of warmth and generosity.

The reality is that we all tend to form an impression of people at least initially on their appearance and feminine attractiveness is founded on curvaceous form.

Last week I was watching the immortal movie classic "Casablanca" on TV and was once again moved by the captivating beauty of the female lead Ingrid Bergman.

Her beauty was characterised by an elegant screen persona complemented by her arresting femininity. Bergman was able to portray both strength and vulnerability into her character .

She had a striking face with a beautiful lip contour that added to the impression of a natural personal warmth. Her lips were well proportioned, curvaceous and balanced--- an aesthetic we try to emulate in clinical practice.

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