Eventually, it happens to everyone: Time, genes, and gravity have their say. One day, our faces are young and firm. The next, not so much.

Included in those eventual changes are wrinkles, sagging, expression marks - and jowls! Found along the bottom part of the face and jaw line, jowls are a fullness or looseness that definitely suggest the aging process is on board.
Like a beach ball (or raisin) deflating due to loss of volume, our facial changes begin when we are in our late 30s, reports Dr. Kevin Hayavi, medical director of Beverly Hills Physicians Institute, which is one of California's largest networks of beauty and health care providers.

This volume loss, Hayavi notes, has been linked to reduction of collagen production, loss of facial fat and decreased elasticity. Production of collagen in our dermal layer is what actually gives our skin its firm (or "fresh and full") appearance. Elastin, a component of collagen and much like elastic itself, actually holds the collagen together. But with time, collagen production wanes, and signs of aging begin, said Esthetician Rosemary Murphy of Beyond Harmony Med Spa in Canyon Country.

Murphy described that "loosening" process: "Picture elastic after it's been washed many times in hot water and that will give you an idea of what happens to collagen and elastin. Add to that, environmental stresses, gravity, and repeated facial expressions and you can see that the skin wears out."

OK, so you have jowls. What are you going to do about them? Maybe nothing. After all, volunteering for treatments to lessen what sags may not be your bag. But in the event you are interested in turning back the clock on your lower face and jaw line, here are some interventional recommendations from our local experts:

For starters, short of surgery, which can offer lasting (often downright amazing) results, there are numerous medical aesthetic options available today.

One such procedure offered at Beverly Hills Physicians is ReFirme, an FDA-approved skin tightening procedure using a highly controlled bi-polar radio frequency (RF) and optical energy.
"ReFirme is a good option," said Hayavi, whose centers include Valencia. "Three to four 20-minute sessions of ReFirme will prevent facial sagging and keeps the skin tight and firm for years to come."

Murphy, whose spa offers a variety of age-defying aides, expressed excitement over the plethora of alternative treatments that have been developed. She notes that many practitioners are realizing excellent results with "fillers." These sag-plumping agents, Murphy said, are either collagen-based or more popular lately is the group of hylauranic acid fillers, including Restylane, Perlane and Juvederm. (She adds that because hylauronic acid is something the body produces, it will be absorbed after several months, necessitating re-injections every six to eight months.)

The newest FDA approved filler, which is exclusively offered in the SCV at Beyond Harmony, is Artefill, Murphy said. Artefill, she said, "is a combination of collagen and (non-absorbable) PMMA microspheres that provide results that last from two to five years and perhaps longer." "I can tell you from personal experience that it is the filler of tomorrow," she added.

Liposuction can generously improve the contour of the chin and jaw in individuals, said Valencia-based plastic surgeon Dr. Edward A. Pechter. With liposuction, unwanted fat deposits are "sucked out" from underneath the skin with a tiny vacuum.

Pechter, who has practiced locally for more than two decades and was trained in the Division of Plastic Surgery at UCLA, says the procedure is performed in his office operating suite and takes about half an hour under twilight sleep or general anesthesia. "Initial recovery is about a week and full recovery takes a couple of months," he said.

For those in their late 40s and older, more invasive procedures such as a face or neck lift may be appropriate for getting back that jowl-free, V-shaped face of youth. These lifts are definitely not the procedures our mothers and grandmothers knew, Hayavi said.

"With medical advances today, facial rejuvenation is more effective and requires minimal down time," Dr. Hayavi stated. "Performed by skilled hands, results are more natural than ever and will last a lifetime."

Jowls, which are caused by sagging fat deposits under the skin at the sides of the jawbone, become increasingly more prominent as we age. This happens because skin in the area is adherent to the jawbone, allowing the fat deposits to sag downward over the stationery skin, Pechter said.

"This is why jowls can easily be elevated by lifting from above while they can't be pulled down from below - because jowls are caused by tissue deep in the skin, they can't be effectively treated by 'skin-only' facelift procedures. Instead, it is necessary to also reposition deeper tissues for effective correction," the Valencia surgeon stated.

A facelift, Pechter said, takes approximately four hours and is performed under general anesthesia or twilight sleep. It also has an initial recovery time of about two weeks, with full recovery taking several months.

Dr. Chrystal Lia Fernandez, RN, PhD, of Bellissima Inc. and Above And Beyond Laser Skin Clinic offers a variety of aesthetic jowl-reducing treatments. They include skin tightening/wrinkle treatments, which, says Fernandez, are "ideal for targeting those tell-tale signs of aging, including jowl and neck laxity."

Laser skin tightening generally requires multiple treatments done once a month, Fernandez said, adding the process "stimulates collagen remodeling, which in turn tightens and firms the skin."

Also among the services lineup at the nurse/scientist/aesthetic specialist's facilities (located in Valencia and Irvine): advanced rejuvenating treatments such as the Liquid Facelift, which can include a combination of injectables such as Botox, Restylane, Juvederm, Radiesse and lipotherapy (a non-surgical "fat-dissolving" method with little or no down time), and much more.

Fernandez, faculty trainer for Allergan (makers of Botox and Juvederm), a member of Beautiful Magazine's board of directors and the American Society for Plastic and Surgical Nurses, says she gets an intrinsic lift out of helping others look better and discover improved self-esteem. "When people are happy in their own skin, it shows!" Fernandez said.

Whether it's rewinding the clock on sagging jowls, or utilizing other aesthetic, age-reversing treatments, the gains received are often well worth the costs involved.

Author's Note: As with any medical or surgical procedure, it is imperative that prospective patients obtain all pertinent information, including risks, benefits and side effects.

For more information...
Dr. Chrystal Lia Fernandez
of Bellissima, Inc. 295-0855
Dr. Edward A. Pechter 255-2151
Dr. Kevin Hayavi of Beverly Hills Physicians 800-788-1416

Results without needles or surgery

Jan Marini Bioglycolic Cream
Bioglycolic Cream Rx dramatically resurfaces skin for a softer, smoother texture; significantly lessens the appearance of fine lines and wrinkles; evens skin tone; and increases overall skin hydration.
available at Beyond Harmony 298-8008

Murad Intensive Wrinkle Reducer
Results are immediate but also improve over time, much due to the "secret" ingredient: Durian Cell Reform, a proprietary blend of Durian and glycolic acid. Durian, an Asian super fruit, enhances the penetration of anti-aging ingredients; reverses the visible signs of aging both on the surface and at the cellular level; provides hydration and antioxidant protection, as well as anti-inflammatory benefits.
available at Beauty Escapade 775-9888

Dermal Solutions Corrective Treatment Systems C-Lift Facial Serum
C-Lift Serum contains high levels of micellized L-ascorbic acid and other important vitamin-based ingredients that help to repair the skin's structure at the cellular level. Vitamin products are only effective when they are forced beneath the skin. Over time, when these vitamins settle under the skin, they help in stimulating collagen and elastin - helping to lift and smooth out the texture of the skin.
available at Dermal Solutions 295-0027

Guinot Liftosome Lifting Creme
The Liftosome facial treatment, best suited for mature skin, aims to energize, tighten and firm using vitamin C to brighten the skin. Liftosome relaxes features, smoothes away fine lines and adds a luminous glow to the complexion. Liftosome products act on two levels: vertically, for a firming action, and horizontally, to tighten the skin.
available at L'esprit Day Spa & Salon 284-3633