Let’s Follow Up about that Jowl Problem

In a recent post, we issued a PSA that outlined what CoolSculpting can and cannot do. Namely, we pointed out that a fat-freezing treatment is not the same thing as a treatment for jowls. Jowls are not made up of fat. They are skin and superficial tissue that have lost firmness and elasticity so no longer sit where they should on the lower face. We understand that jowls are incredibly problematic. No one looks forward to the time when their face starts to look as though it’s melting. Here, we discuss some of the reasons why jowls develop and what you can do to address this problem.

Why We Get Jowls

Several factors contribute to the development of jowls. These include:

  • Most of us will get some degree of jowls as we age. Our genes don’t decide this. What they do influence is how severe our jowls may become. Don’t worry, we can work against this factor!
  • Of course, jowls are an age-related problem. They develop because the body stops making its normal amounts of collagen and elastin. Without sufficient amounts of these chemicals, the skin loosens. It’s that simple. Can we work against it? You bet!
  • How we live greatly effects how we look. Jowls may be made worse by factors such as UV exposure, weight changes, smoking, and the use of our beloved smartphone (tech neck, it’s a real thing!).

How We Can Help You Become Jowl-Free

There are several ways to approach jowls. In our La Casita and Sonterra offices, we’ve got energy devices as well as injectables at our disposal for this very problem.

Skin Tightening Treatment

Seeing that the quality of the skin is partly responsible for jowls, we may suggest energy-based procedures for some patients. The use of radiofrequency, ultrasound, and other technologies does two things. First, it causes collagen strands to constrict by heating them. Then, the heat that gets absorbed into the dermis stimulates fibroblasts to make more collagen. Thus, over time, the skin becomes firmer and more resilient (less likely to sag into jowls).

Fillers

It may seem illogical to consider dermal fillers as a part of jowl treatment. It’s not. Another contributing factor to sagging in the lower face is deflation in the mid-face. With age, the fat pads of the cheeks degrade. Without sufficient fat to contour the mid-face, skin starts to slip. Where does it land? At the jawline. A little contouring of the cheekbones with a viscous dermal filler may be all it takes to lift sagging skin upwards.

The time for jowls to go is now. To schedule a consultation and explore your treatment options, call our Sonterra or La Casita office in San Antonio.

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Exciting News – We’re Moving!

For 35 years, as a board-certified dermatologist, I have provided compassionate and exceptional care while offering the latest advancements in skin health and rejuvenation.

 

Health care continues to evolve toward regenerative medicine and longevity, and dermatology is no exception.

 

My core beliefs are that health and beauty are not mutually exclusive, but beauty must never come at the expense of health. Skin health is foundational to overall wellness, and my mission is to empower every patient with the education and tools to optimize skin health.

 

In this spirit, I am thrilled to announce that effective August 3, 2026, the Hardy Oak location of Bucay Dermatology and Aesthetics will have a new home at Stone Oak Physician’s Plaza II, where I will be sharing a wonderful space with Dr. Michelle Harden, MD, Concierge Women’s Health, Menopause, Lifestyle Medicine.

 

I cannot think of a better setting that reflects the future of comprehensive wellness, regenerative care, and healthy aging.

 

I look forward to welcoming both our longtime patients and those visiting us for the first time to our new location:

 

Stone Oak Physician’s Plaza II

540 Oak Centre Drive, Suite 280

San Antonio, TX 78258

 

Now accepting new patients

To schedule your appointment, please call 210.692.3000

 

I am grateful for your trust and confidence – Vivian Bucay, MD

 

P.S. Of course, we will continue to welcome patients to our “La Casita” Monte Vista location at:

La Casita

326 W. Craig Place

San Antonio, TX 78212

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