DFW Skin Surgery Center
1115 W. Randol Mill Rd
Suite 200
 Arlington, TX 76012
(817) 303-6647 (MOHS)
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DFW Skin Surgery Center, PLLC
1115 W. Randol Mill Road, Suite 200, Arlington, TX 76012
(817) 303-6647 (MOHS)
Fax: (817) 303-6651


©2012-2014 DFW Skin Surgery Center, PLLC. All Rights Reserved.

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Treatment of Jowls and Facial Contouring
Jowls are a common complaint, which can arise as a result of natural aging and in response to prolonged sun exposure, in a process called photoaging. The latter process may also be associated with other signs of photodamage, such as irregular skin tone, brown spots, broken capillaries, altered skin texture, enlarged pores, and skin laxity.

Though previous treatments centered on the diminution of specific lines, such as the marionette lines, resulting from jowl formation, or on the removal of excessive skin, as in facelifts, it has recently become apparent that a proper correction needs to address the underlying loss of facial volume and the restoration of a more youthful contour.

Facial structures, such as collagen, fat, and even bone, begin to get resorbed over time, resulting in a conspicuous loss of volume, often most prominent over the temples, cheek bones, and cheeks. Thus, the underlying “scaffolding” is lost and the overlying skin begins to descend, thus contributing to jowl formation. Also, facial shape is thus changed from a smooth, round contour beginning on the side of the forehead down to the jawline, as seen in a younger face, to a more undulating profile often seen in middle age and beyond. Even if other procedures, such as skin tightening or a facelift, are contemplated, this loss of facial volume should be addressed to create a truly rejuvenated appearance.

Fillers are agents that are used to temporarily correct volume loss. Many types of filler are available on the market today for facial volumization, including hyaluronic acid products (such as Perlane and Juvederm Ultra Plus), calcium hydroxylapatite (Radiesse), and poly-L-lactic acid (Sculptra). These agents vary in their applicability to different locations and duration. Sculptra, a newer filler agent, also stimulates production of collagen, the underlying tissue of the skin. As a result, Sculptra actually replaces medium and large volume deficiencies with one’s own new natural collagen.

Following volume correction, skin tightening may be achieved with a variety of lasers and laser-like devices, such as laser resurfacing. Laser resurfacing options include ablative resurfacing (that is, one that completely removes the outer layer of the skin), non-ablative resurfacing, and fractional resurfacing. All types of laser resurfacing are based on the ability of the laser beam to penetrate deep into the skin, heat and tighten existing collagen molecules, and cause new collagen formation. Though generally not as effective, non-ablative resurfacing produces no external skin wound, allowing patients to return to their activities with no downtime. Fractional resurfacing produces pinpoint skin surface rejuvenation, resulting in faster and more prominent improvement, though at a cost of slightly longer downtime.

If you would like to find out more about these or any other procedures or would like to schedule a personal consultation with Dr. Berlin, please contact our office today or use the form on the right to request more information.