SAGGING SKIN AND JOWLS

THERE ARE TWO main reasons for jowls and sagging in the lower part of the face: skin laxity (due to loss of collagen and elastin) and decreased volume in the cheeks (caused by fat atrophy and thinning of the cheekbones). All of these changes are a natural part of getting older.

Usually, a two-pronged approach is best for treatment. The first step is dermal filler being injected into the cheeks. “I call it building a foundation,” says Victoria-based dermatologist Dr. Mark Lupin. “You start deep and work toward the surface.” Adding volume back to the cheeks with one to six syringes of filler will lift the skin in the lower part of the face.

Then, your doctor or medical esthetician will likely recommend a skin-tightening treatment that uses radio-frequency technology. Thermage and Refirme, for example, heat the collagen deep in the skin, prompting it to contract and tighten and kick-starting the skin’s natural renewal process.

PAIN AND DOWNTIME: Pain is minimal, though some patients will take an oral analgesic.

$$$: $1,500 to $2,100 for one Thermage treatment. Most people require one treatment, but some may opt for a second treatment three months later. Meanwhile, each Refirme treatment costs $250 to $500. Six treatments, each one or two weeks apart, are required.

LASTING EFFECTS: Up to two years for Thermage, and about a year for Refirme