Jowls

 Eye Bags

Tired Eyes

Heavy Neck

Sun Spots/Pigmentation

Thin Lips

Lines and Wrinkles

Hair Loss

Jowls

Understanding Jowls

Jowls are a common concern that develop as the skin loses elasticity and facial volume over time. Gravity continuously pulls downward on our skin, and when the underlying structures shift, sagging along the mid-face occurs—what we commonly call jowls.

As illustrated in the diagram, much of what we associate with an aged appearance is the result of changes beneath the skin, including loss of bone density and fat. Notice how the diagram demonstrates the transformation of the facial support system as we age.

Solution 

Our Approach to Correction

Restoring youthful contours in the midface and correcting jowling requires a personalized approach. True rejuvenation is achieved not just by tightening the skin, but by repositioning both the skin and the underlying muscle.

Think of it like making a bed: simply smoothing the blanket leaves bumps beneath the surface. Similarly, addressing only the skin does not create a natural or lasting outcome. By repositioning the deeper muscle layer along with the skin, we create results that are both more durable and more natural.

If you’ve ever worried about a “pulled” or unnatural look, you’re not alone. Our surgeons carefully use photographs from your younger years to establish realistic goals. The focus is on restoration—not change—helping you look like the best version of yourself, with a naturally youthful appearance that feels authentic.

 Procedures 

At Facial Aesthetic Concepts, we offer advanced surgical solutions to restore youthful definition to the lower face and neck.

• Deep Neck Contouring refines the neck and jawline by addressing sagging skin, excess fat, muscle bands, and early jowling. By working on the deeper structures, this procedure restores a smooth, sculpted profile with natural, lasting results.

• Neck Lift Surgery is a highly effective option for patients experiencing more significant laxity or stubborn fat. By tightening loose skin and redefining the underlying structure, a neck lift improves the overall profile and reduces the appearance of jowls. It can be performed on its own or combined with a facelift for more comprehensive rejuvenation.

Both procedures are tailored to your unique needs, helping you achieve a more youthful, confident appearance.

 Treatments 

For patients with mild to moderate jowling, non-surgical skin tightening can provide noticeable improvement without downtime.

• Sofwave® uses advanced ultrasound technology to stimulate collagen production, tightening and lifting the skin over time. Results develop gradually over several months, creating a smoother, firmer jawline and improved definition.

• DVDRF (Radiofrequency Microneedling) combines the collagen-stimulating benefits of microneedling with radiofrequency energy delivered deep into the skin. This dual approach not only improves skin texture and tightness but also effectively reduces jowling by remodeling the underlying support structures. The result is firmer, more lifted skin along the jawline with minimal downtime.

Both treatments are safe, non-invasive, and ideal for patients who want a subtle yet meaningful improvement in facial definition without surgery.

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Eye Bags

Eye bags are produced by changes to the skin beneath the eye and/or the fat beneath the skin under the eye.  As we age the muscle surrounding the eye weakens producing changes in the fat distribution around the eye creating the appearance of puffiness or ‘eyebags’.  The thin skin beneath the eyes is particularly susceptible to a loss of elasticity producing fine lines and a ‘crepey’ texture. 

Solution

To address eyebags we look at whether the fat or the skin beneath the eye is creating the problem to determine the best procedure option.  When just crepey, wrinkled skin is seen beneath the eyes we are able to create a very nice improvement by just addressing the skin.  Heavier bags are commonly produced by fat pat herniation that can be corrected by a minor procedure to correct the herniation and reposition the fat to restore a soft, natural undereye contour. 

Procedures

If we are focusing on just skin beneath the eye we often use a procedure developed by Dr. Gangnes called a Lower Lid Pinch.  This procedure uses a medication that frees the skin beneath the eye from the underlying muscle allowing the doctor to ‘pinch’ the loose skin and restore a smooth lower lid contour.  If fat repositioning is necessary the doctor accesses the fat through the inside of the lid and restores the correct position of the fat to produce a smooth, natural under eye contour. 

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Heavy Neck

Heavy necks are common concern that is produced by a loss of skin elasticity, changes to the underlying skin structure or fat accumulation in the neck. Gravity is continually pulling on the neck and the loss of skin elasticity lets gravity start to win the battle. In some cases, it may be the muscle and tendons in the neck that have become weaker over time and create a sagging that many patients would like to correct. As with many common concerns we hear from patients, necks are a very individualized concern with a variety of issues that may need to be addressed.

Correction

To restore a smooth neck line we look at the underlying cause to determine the best treatment option. Our approach varies depending upon whether we want to address skin, muscle, fat accumulation or a combination of these. During a consultation you will discuss the issues with your physician and determine the approach to produce the best outcome.

Procedures

We use a necklift or liposuction to address many of the common patient concerns with their neck. The necklift is a customized approach to restore youthful anatomy creating a smooth, contoured neckline. The procedure may combine techniques to address both muscle and connective tissue to reposition how the skin lays on the neck and smooth the contours beneath the chin. If excess fat is causing ‘heaviness’ beneath the chin, liposuction is used to remove the fat and improve the appearance of the neckline.

Treatments

We can use radio frequency technology to tighten the skin beneath the neck. Thermitight uses targeted radio frequency energy delivered beneath the skin to tighten and smooth neck contours.

Thermage is another option which uses radio frequency energy applied to the skin to stimulate and tighten the skin.

Tired Eyes

Our Approach

Our approach is centered on restoring natural balance around the eyes, rather than simply tightening skin or removing tissue in isolation. The eye area is complex, and a tired appearance is rarely caused by just one issue—so focusing on a single fix can lead to results that look overdone or incomplete.

Instead, we evaluate and address the full picture: volume loss, contour changes, and skin quality. By carefully restoring volume where it has diminished, refining the transition between the eyelid and cheek, and improving skin texture and tone, we create a more harmonious, well-supported eye area. This comprehensive approach allows for results that look brighter, smoother, and naturally refreshed—never pulled or artificial.

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Sun Spots/Pigmentation

Uneven skin tone is a plague of sunny Southern California.  Sun damage is the leading cause of pigmentation irregularity.  When UV rays are absorbed by the skin the skin responds by producing melanin, pigment, to protect itself.  Unfortunately, melanin distribution in the skin is not always consistent which is typically the cause of the ‘sun spots’ seen in skin. 

Solution

The best protection against sun damage is daily use of sun screen.  Even in the cloudy and cool winter your skin can be damaged by sun exposure.  If the damage has already been done there are excellent options for improving irregular pigmentation and evening out skin tone.  Light based technologies and certain types of lasers break up the pigment in the skin creating a more even skin tone. 

Treatments

Light chemical peels with estheticians are a great way to help exfoliate the skin and reduce irregular pigmentation.  Photofacials are a no downtime solution that patients love to help maintain beautiful smooth skin. 

Other options include fractional CO2, chemical peels, and photodynamic therapy. 

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Thin Lips

Thin lips are an easily improved part of ones appearance.  There are really two common causes of thin lips.  Many patients have little volume in their lips which is the most common cause of thin lips.  Some individuals have an elongated upper lip that allows the upper lip to appear very thin and hang over the teeth.

Solution

For the majority of patients volume augmentation with fillers is the easiest and most effective means of achieving a perfect ‘pout’.  This procedure involves a small amount of product to be injected into and around the lips to both plump and smooth the area around the mouth. 

Treatments

We commonly use either Juvederm or Restylane to enhance the appearance of the lips.  This is a great treatment option and can last more than 6 months. 

Procedures

There are two procedural options for a greater longevity of result.  Fat transfer involves harvesting your own fat processing it and injecting it back into the lips.  Fat transfer can produce a much longer term result than fillers and is a better option for some patients. 

For select patients that have an elongated upper lip a Lip Lift may be an option to produce a permanent improvement in the appearance of a thin upper lip.  This involves using a small suture beneath the skin to reposition the muscle of the upper lip producing an improved upturn in the upper lip and a ‘pouty’ look.

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Lines and Wrinkles

Wrinkles are usually the first things we begin to notice when we look in the mirror.  Wrinkles are caused by two primary issues dynamic facial movement and loss of facial support structure.  As we age changes in the skin’s elasticity don’t allow it to ‘snap’ back the way it used to so lines and wrinkles cause by movement become etched in the skin.  In addition, as illustrated in the diagram the loss of bone and fat beneath the skin is what produces much of what we associate with an aged appearance.  Notice the change in the diagram and how the support structure within the face changes. 

Solution

Lines and wrinkles can be corrected by eliminating the cause of the wrinkle, such as movement or anatomical changes, or by stimulating the skin to ‘grow’ or improve itself.  For wrinkles caused by movement we inactivate targeted muscles responsible for creating lines and wrinkles to smooth the skin and help prevent permanent etching of lines in the skin. 

Some deeper wrinkles and folds are caused by changes in the underlying structure of the skin.  The changes can include both loss of bone and fat, the structure beneath the skin.  We restore that structure using fillers, fat transfer, or procedures.  The skin itself is treated by a variety of different tools used to stimulate the skin to regrow collagen and improve the structural elements that can smooth lines and wrinkles.

Procedures

Fat transfer is a quick procedure with very little ‘downtime’.  It involves harvesting a patients own fat from the thighs or buttocks and reinjecting it into areas where fat loss has created an aged appearance.  Fat transfer is used throughout the face to restore both restore and beautify facial contours. 

For deeper lines and wrinkles a minimally invasive procedure like the Microlift or Extended Microlift is used to restore the position of the skin and muscle to improve the underlying structure without the downtime associated with typical facial surgery. 

Treatments

Many treatments can help with fine lines and wrinkles depending on the depth Botox and fillers are perhaps the greatest combination of treatments that produce the best outcome for patients with concerns about lines and wrinkles. 

Botox is used to inactivate muscles that create dynamic facial wrinkles, like those around the eyes and forehead, and help to prevent the permanent imprint of wrinkles. 

Fillers are useful for a variety of different areas of facial wrinkles.  Take a look at the illustration to see an example of where fillers are commonly used.  Fillers allow us to restore natural, youthful contours without downtime.  We use pictures of our patients from their younger years to help guide our technique and provide us a goal for treatment outcomes.  Some patients are reluctant to try fillers because they have seen friends with ‘bad filler’.  At FAC we perform more botox and filler than anyone else in Orange County, so our staff is highly experienced, and we take a conservative approach to give our patients a natural, refreshed look.

In addition to Botox and filler, we have a broad variety of technologies that stimulate the skin to produce collagen which improves the skin structure and minimizes the appearance of lines and wrinkles.  We use radio frequency technologies such as Thermage, Pelleve, and ThermiSmooth to stimulate and smooth skin texture. We also use light based technologies such as lasers and IPL to stimulate collagen which improves the texture and appearance of the skin.

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Hair Loss

Hair loss is traditionally associated with men but women also suffer from thinning hair and aren’t familiar with the options available to them. Hair transplants are the only option to improve thinning hair. We have a non-surgical approach to thinning hair that includes platelet rich plasma, medications, and LED photomodulation to regrow hair and thicken the appearance of the hair.

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