Home » Blog » Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Jowl “Pockets” and Facial Laxity

Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Jowl “Pockets” and Facial Laxity

Dr. Dean Kane Q. What is the best treatment for lower face when “pockets” start on sides of mouth? Do I need a lift, volume or injections? I’ve been told to get volume in cheeks, injections in chin and lasers to lift to name a few. I’m just not sure!

A. Thanks for sharing your photo. 

The beginnings of facial skin laxity start when skin repair diminishes and passive skin aging relaxes downward. The web of fibrous compartments under the skin loses fat, stretches and elongates developing 5 growing “waves” of skin at points of attachment such as the:

  • hooding along the eyes,
  • lower eyelid / cheek junction or tear trough / nasojugal fold
  • nasolabial fold,
  • lateral mouth commissure and marionette folds, (your “pockets”)
  • jowls and neck.

Facial Aging are created from the 5 different layers of the skin, fat, muscle and bone. During the first 20 years or so of life, the body genetically determines how to develop and repair a constantly changing “face” including all these layers (as it does elsewhere in the body). Thereafter it remains robust in repairing itself from injury but the accumulation of environmental, health and nutritional exposure will add to the passive inability for the body to care for itself after 30. This is when physical changes such as skin laxity, irregular pigmentation, lines and wrinkles and skin diseases occur. We now have many options to rejuvenate the layer or layers of the face which need care or stimulation to reverse the aging trend.

So, it is important to understand there are 2 layers of the face and neck to rejuvenate; the laxed visible skin AND the sagging soft tissues under the skin. 

Today’s options offer non-invasive, minimally invasive and surgical options. In general:

  • The lower face can be reduced, lifted, tightened, and / or
  • The mid-face can be filled. 

Since I do not have the advantage to examine you, I hope you will be helped by the information below. My immediate recommendations are to obtain:

  • consultation with a talented, Board Certified Plastic Surgeon with extensive skills in:
  • non-surgical skin tightening using Obagi ZO Skin Health Rx regimen and chemical peels
  • minimally invasive injectables including fillers and / or fat to the mid-middle-lateral upper cheek
  • Minimally invasive EuroThreads of soft tissues and skin, ie 2 layers for 

o    firming and tightening of the dermal skin layer

o    lifting of the jowl and marionette / lateral commissures / nasolabial folds

o    lifting of the jowl directly upward back to the middle upper cheek.

Everyone needs one or more layered improvement and in personalized combinations to achieve their optimal result. You can understand why it takes a talented individual, preferably a Board Certified Plastic Surgeon with great experience to evaluate your needs and find a plan that works best for you. All surgical, minimally invasive and non-invasive procedures and their combinations should be discussed following a proper examination with a well versed, Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he limited in his skills.

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This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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