Q, I am fed up with my jowls.  I'm normal weight and thinking of embarking on injectables. I hoped serums would help but they don't fulfil their promises. Any helpful advice please?

A. Jowls are an issue many people face as they age, according to leading cosmetic doctor Dr. Rita Rakus (drritarakus.com), whose Knightsbridge clinic is a byword for knowledgeable and experienced advice and treatments. We asked Dr. Rakus for her advice on options.

‘Drooping skin is the result of elastin and collagen levels within the dermal layer of the skin depleting naturally with age. This leads to the jawline sagging and forming jowls, which drag the face down and add years to your appearance,’ she says. ‘Serums can be wonderfully useful for reducing the appearance of fine lines, as they may reduce wrinkle depth, but non-prescription cosmetics simply cannot penetrate the skin deeply enough to lift jowls.’

Dr. Rakus advises that facial fillers are can be a great minimally invasive jowl buster, ‘which will provide visible lifting results. Injecting small amounts of filler into the cheeks, marionette lines and nasal area can restore lost volume in the skin and lift the jawline making jowls look less prominent.’

Botox can also be used to gently lift the neck and jawline, Dr. Rakus explains.   Her preferred method is the ‘Nefertiti Lift’. This involves pinpointing and then injecting Botox into depressor muscles in the lower area of the face. This, in turns, allows the elevator muscles to pull up specific features, resulting in a smoother, more toned neck and jaw.

There is also a non-invasive alternative, she says. ‘ULTRAcel offers the perfect, non-surgical solution. This clinically proven procedure combines radiofrequency with ultrasound technology to tighten and contour your skin. Its combination technology stimulates and renews the skin’s collagen production to tone and tighten the face, neck and décolletage for smoother younger looking skin.’

For clients with a particularly loose jawline or in need of more pronounced results, ULTRAcel can be combined with Thread Lift by Silhouette Soft. ‘Thread Lifts provide immediate, long-lasting results for the neck, jawline and lower facial area,’ says Dr, Rakus. ‘The lifting effect is the result of compressing and elevating tissue when the suture is applied. After inserting the suture, the doctor applies slight pressure on the treated area to gently reshape the surface of the skin and make it visibly smoother. The regenerative effect is gradual and natural.’

Dr. Rakus adds that ‘polylactic acid (PLA), the principal component of Thread Lift, is a polymer that has been used in the medical field for many years. [Derived from renewable sources eg corn starch or sugar cane], PLA is particularly biocompatible with human tissues. Once the suture is applied, the PLA acts on the deeper layers of the skin and helps increase the volume of saggy areas, restoring shapeliness to the face gradually and naturally. The combined treatments [in the hands of experienced practitioners] can leave your jawline jowl free and looking years younger,’ she says.

Finally, Dr. Rakus cites Exilis. ‘This offers a revolutionary, non-invasive form of treatment for the reduction of wrinkles and for the reshaping of targeted fat deposits. The treatment involves a computer-controlled device, which is guided over the treatment area. You feel a warming sensation as the energy is delivered to the deeper layers of skin. Exilis focuses the energy on the specific treatment areas at the targeted depth of penetration. By causing the collagen supporting tissues to remodel, Exilis stimulates and strengthens the collagen network to improve skin laxity and texture, therefore reducing the appearance of jowls.’

Meanwhile, we'd also point you in the direction of our Beauty Bible Award-winning NECK TREATMENTS, here. Testers were super-impressed with several of these.