Jowls are one of the most common signs of aging—and one of the first areas people notice when the face begins to lose firmness. As collagen production decreases and facial support structures soften, the jawline can appear less defined, leading to sagging skin along the lower face. But here’s the good news: you do not need a surgical facelift to improve jowls. Modern, non-surgical dermatology has evolved to offer lifted, sculpted, and natural-looking results with little to no downtime.
Jowl formation is influenced by:
Understanding why your jowls formed allows us to determine the most effective treatment plan for restoring shape and balance.
There are several proven non-surgical treatments that can lift and firm the jawline, restore youthful structure, and refine lower-face contour.
1. Skin Tightening with Ultrasound or Radiofrequency
Treatments such as Ultherapy® and RF Microneedling work by stimulating deep collagen remodeling, tightening the skin from within.
Benefits include:
2. Injectable Lifting and Contouring
Strategically placed injectables can restore support and redefine the jawline without looking “filled.”
This may include:
Results continue to improve over time as collagen production is stimulated.
3. Skin Firming and Collagen-Boosting Skincare
Targeted medical-grade skincare can strengthen the skin and prevent further laxity. Key ingredients we typically recommend:
Clinical skincare is especially effective when combined with in-office procedures.
4. Non-Surgical “Liquid Lift” Approach
For patients experiencing both sagging and volume loss, a customized combination approach works best. This may include:
This approach focuses on bringing everything back into proportion—creating a result that is refined, lifted, and harmonious rather than “done.”
If you’re starting to notice jowls or loss of jawline definition, now is the perfect time to explore your treatment options. Early, targeted intervention can slow progression and restore youthful facial structure long term.
Book a consultation today to receive a personalized jawline assessment and treatment plan designed just for you.
Book Online or call your nearest NicholsMD location to schedule.
When it comes to achieving a lifted, more youthful look without surgery, Ultherapy® remains one of the most trusted treatments in medical aesthetics. At NicholsMD, we specialize in natural-looking, refined rejuvenation, and Ultherapy aligns perfectly with our belief that results should be subtle, elegant, and true to you.
This non-invasive ultrasound treatment tightens, lifts, and restores firmness to areas like the jawline, chin, neck, brow, and décolletage—all without downtime or injections. It’s an excellent solution for patients who are beginning to notice signs of aging, such as skin laxity, softening along the jawline, or creasing in the neck and chest.
Ultherapy is the only FDA-cleared treatment that uses focused ultrasound energy to stimulate collagen production at the deeper structural layers of the skin—the same layers addressed in surgical facelifts.
Most skin-tightening treatments work superficially, but Ultherapy targets the SMAS layer, helping to:
The result is a naturally lifted, refreshed appearance—without altering your natural facial expression or contours.
During treatment, ultrasound imaging allows our expert providers to see exactly where collagen support is needed. Focused ultrasound energy is then delivered to those precise depths, prompting your body’s own collagen-building response.
Because the results rely on your body’s natural regenerative process, they develop gradually and beautifully over 8–12 weeks and continue to improve for months.
Ultherapy is ideal if you:
At NicholsMD, all Ultherapy treatments are performed by our highly trained medical providers with precise mapping, customized depth selection, and refined technique to ensure comfort, safety, and elevated results.
As a boutique, concierge-style dermatology practice, we provide:
We are committed to delivering results that feel authentic, refined, and confidence-building.
Discover how Ultherapy can restore your most lifted, defined, and radiant self.
Book your Ultherapy consultation today and experience luxury aesthetic care designed uniquely for you.
Book Online or call us at your nearest NicholsMD location.
GLP-1 medications have transformed the landscape of health and weight management, helping many achieve long-awaited goals. But as body composition shifts, one common and often overlooked side effect can emerge: muscle loss.
While these medications promote fat reduction, they can also decrease lean muscle mass – which plays a crucial role in metabolism, strength, and overall skin tightness. At NicholsMD, we take a science-backed and personalized approach to help you stay strong, sculpted, and supported throughout your GLP-1 journey.
Rebuild Strength with EmSculpt®
Our EmSculpt® technology uses high-intensity electromagnetic energy to trigger powerful muscle contractions that you simply can’t achieve through exercise alone. In a single session, your body performs the equivalent of 20,000 crunches or squats, helping to rebuild and tone muscle in key areas like the abdomen, glutes, and arms.
Restore Balance with Hormone Replacement Therapy (HRT)
Hormonal shifts, especially during perimenopause and menopause, can contribute to fatigue, slower recovery, and loss of muscle tone. Through customized, bioidentical Hormone Replacement Therapy, our expert team helps restore your body’s optimal balance – supporting energy, metabolism, and lean muscle maintenance from within.
Track Progress with SECA Body Analysis
At NicholsMD, we don’t just treat – we track. Using advanced SECA body composition technology, we measure lean muscle mass, body fat, and water balance to ensure your results are not only visible but measurable.
Whether you started GLP-1 therapy elsewhere or are exploring it with us, our team provides a comprehensive, concierge-level plan to help you look and feel your strongest – inside and out.
Book your consultation today to rebuild, rebalance, and redefine your body with NicholsMD.
By Dr. Kim Nichols | NicholsMD of Greenwich, CT
Have you ever looked in the mirror and felt like your reflection just doesn’t look quite like you anymore? It’s not a dramatic change – just something subtle that feels off. I see this often, and it’s something I call Perception Drift.
What Is Perception Drift?
Over time, small cosmetic treatments – especially when done by different injectors or without a long-term plan – can slowly alter the balance of your face. These subtle tweaks add up, and because the change happens gradually, you may not even notice until one day a photo, a friend’s comment, or your own intuition makes you pause.
This moment can be confusing and discouraging. You might think, “What happened? How can I get back to looking like myself again?” The good news is that it’s absolutely fixable – with the right expertise.
The Art of Facial Rebalancing
At NicholsMD, our goal isn’t to do more—it’s to do right. Rebalancing the face requires an advanced understanding of facial anatomy, proportion, and movement, not just a syringe of filler. When you visit my team for a consultation, we take a holistic approach:
Sometimes that means dissolving old filler that has shifted or settled incorrectly. Other times, it’s about refining your treatment plan – using collagen-stimulating treatments, lifting techniques, or skin-quality lasers rather than adding more volume. Every plan is fully customized, designed for natural, timeless rejuvenation.
When Balance Is Restored, Everything Aligns
The most beautiful results are those you can’t quite pinpoint – you just look refreshed, rested, and authentically yourself. True facial rejuvenation isn’t about changing your features; it’s about restoring proportion and confidence.
At NicholsMD, we specialize in:
Ready to Feel Like Yourself Again?
If you’ve had treatments elsewhere and something doesn’t feel right, or if you simply want to reset and rebalance your aesthetic journey, know that it can be done – gracefully and safely.
Book a consultation at NicholsMD of Greenwich, NicholsMD of Fairfield, or SkinLab in Harbor Point to restore harmony to your face and confidence to your reflection. Because when your face is in balance, everything else – your energy, your expression, your confidence—follows.
Schedule your consultation today.
If you’ve ever been told to stop using retinol in the summer or while on vacation, you’re not alone. As one of the most misunderstood skincare ingredients, retinol often gets a bad reputation for being “too strong” or “too reactive” under the sun. But as Dr. Kim Nichols explains, the truth is much simpler – and much more scientific.
1. Why Retinol Is a Nighttime Essential
Retinol, a derivative of Vitamin A, is one of the most powerful and proven ingredients in dermatology for improving fine lines, wrinkles, texture, and acne. However, its active components break down when exposed to UV light.
That’s why your dermatologist – and every trusted NicholsMD skincare protocol – recommends applying retinol only at night. While you sleep, retinol gets to work, stimulating cell turnover and collagen renewal without interference from sunlight.
In the morning, washing your face and following with vitamin C and broad-spectrum sunscreen keeps your skin protected and radiant.
2. Retinol and the “Vacation Myth”
A common misconception is that you should stop using retinol before traveling to sunny destinations or during summer months. The truth? You can absolutely continue using retinol year-round, as long as you’re diligent about daily SPF.
Retinol itself doesn’t make you “burn easier.” What happens is that your skin becomes more photosensitive – meaning you need to be extra mindful about sunscreen and reapplication. But abandoning your retinol routine every summer means missing out on months of visible progress.
At NicholsMD, we often customize patients’ routines to include gentler retinol formulations during warmer months or after sun exposure – keeping your results consistent and your skin barrier protected.
3. The Trifecta: The Three Essentials for Healthy, Glowing Skin
Dr. Nichols is known for her signature Skincare Trifecta – three products that form the foundation of every great skincare routine:
When used together consistently, this trio delivers a NicholsMD glow – healthy, smooth, and youthful skin that lasts all year long.
4. The Bottom Line: Retinol Isn’t the Enemy – It’s Your Skin’s Best Friend
Retinol isn’t a seasonal ingredient. It’s a cornerstone of long-term skin health, backed by decades of research and results. The key is using it correctly: at night, with SPF during the day, and under professional guidance to ensure your formula suits your skin type.
At NicholsMD, our team of skincare experts and master aestheticians design personalized regimens that make even powerful actives like retinol gentle, effective, and effortless to use. Browse our collection of medical-grade skincare, or shop our favorite retinol products online today.
In the world of aesthetics and wellness, the term “microdosing” has become a trendy buzzword – from microdosing skincare and retinoids to injectables like Botox and even GLP-1 medications. The idea sounds appealing: use tiny, frequent doses to achieve gentle results with fewer side effects. But when it comes to dermatology and medical treatments, this “less is more” approach can actually undermine your results – and your safety.
1. Evidence-Based Dosing Matters
Prescription-strength skincare ingredients and medications are clinically tested at specific doses to deliver safe, measurable outcomes. When you use too little – or use it inconsistently – your skin doesn’t get the therapeutic benefit it needs. You may still experience irritation, yet never see visible improvements.
The same applies to in-office treatments like Botox or Dysport. Microdosing these injectables often leads to unpredictable or short-lived results, requiring more frequent touch-ups and costing you more in the long run.
2. The Dangers of Microdosing GLP-1 Medications
Medications such as semaglutide (Ozempic®) and tirzepatide (Mounjaro®) are designed to be taken at specific, research-backed doses. Reducing or self-adjusting your dose without medical supervision can cause nausea, blood sugar fluctuations, resistance, or rebound weight gain – while completely negating their metabolic and cardiovascular benefits.
At NicholsMD, our Longevity and Wellness Programs carefully monitor dosing and progress to help you achieve sustainable results, not quick fixes.
3. Hair Loss Treatments: Minoxidil Needs Precision
Whether used topically or orally, minoxidil works best when taken at evidence-based doses that balance safety and efficacy. Microdosing often leads to the worst of both worlds – too weak to stimulate meaningful hair growth, yet still strong enough to cause side effects like scalp irritation or shedding cycles.
4. Accutane (Isotretinoin) Is Not for Guesswork
As one of the most powerful acne treatments available, Accutane must be prescribed at the correct dose and duration under dermatologic supervision. Microdosing isotretinoin may fail to clear acne completely, increase your risk of side effects, and prolong exposure without benefit.
At NicholsMD, each Accutane course is customized and monitored monthly to ensure clear, lasting results with minimal risk.
5. The Bottom Line: Skip the Shortcuts
In aesthetics, “microdoing” might sound harmless, but it’s often a shortcut that leads to disappointment. Science, not guesswork, delivers real results. As Dr. Nichols emphasizes:
“My goal is always to deliver safe, lasting, and beautiful results – using evidence-based dosing tailored to your unique needs.”
If you’re considering any skincare, injectable, or wellness treatment, book a conultation with our Team today.
If you’ve ever wondered about the difference between dermal fillers and Sculptra, you’re not alone. Many patients visit NicholsMD asking which option will give them the best, most natural-looking results. The truth is—they work beautifully together when used strategically.
Dermal fillers are made from hyaluronic acid, a molecule naturally found in our skin that attracts and retains moisture. At NicholsMD, Dr. Kim Nichols and her team use premium HA fillers to restore lost volume, smooth wrinkles, and enhance natural facial features.
Common treatment areas include:
Results from fillers are immediate, making them ideal for anyone who wants instant rejuvenation. Most results last 12–18 months, with occasional touch-ups depending on the product and placement.
Sculptra is not a filler – it’s a biostimulator. Instead of adding volume directly, Sculptra stimulates your skin’s own collagen production to gradually restore firmness and elasticity.
Dr. Nichols often uses Sculptra for:
Sculptra typically requires two to three sessions spaced several weeks apart, with results building over time. Once full correction is achieved, a yearly maintenance treatment helps keep collagen levels-and your glow – high.
Beyond lift and volume, patients love what we call the “Sculptra Glow.” As collagen regenerates, skin texture improves, pores refine, and the complexion looks visibly healthier and more radiant. It’s not just about structure – it’s about skin quality, too.
When it comes to facial balancing, it’s rarely about choosing one over the other. At NicholsMD, most patients benefit from a customized combination of both:
Together, these treatments help create the most balanced, refreshed, and natural look – never overdone, always you.
Schedule your consultation at NicholsMD of Greenwich, SkinLab by NicholsMD in Harbor Point, or NicholsMD of Fairfield today. Let our team design a personalized plan for timeless, radiant confidence.
When it comes to anti-aging skincare, most of us focus on our face, neck, and décolleté – but there’s one area that often gives away our age first: our hands. From sunspots and fine lines to loss of volume and visible veins, the hands can reveal years of sun exposure and environmental stress. Luckily, there are powerful ways to both prevent and treat the signs of aging hands.
The number one rule? Treat your hands like your face.
Everything you’re already using on your face, neck, and chest – from hyaluronic acid and vitamin C serums to antioxidants, ceramide-rich moisturizers, and retinol – can and should be applied to your hands as well. Products that boost hydration and collagen production will help improve elasticity and smooth crepiness over time.
For those incorporating advanced ingredients, exosomes (like Plated™ Skin Science) can further stimulate collagen and rejuvenate the skin barrier for smoother, more resilient hands.
Prevention goes beyond products. Everyday habits play a huge role in how your hands age.
If you’re already seeing signs of aging, in-office treatments can restore volume, tone, and texture beautifully:
These advanced procedures can be combined for a truly comprehensive hand rejuvenation plan – restoring youthful volume, texture, and tone.
Your hands deserve the same care and attention as your face. Consistent daily protection and hydration, paired with strategic in-office treatments, can dramatically reduce the visible signs of aging.
At NicholsMD Dermatology, we specialize in preventive anti-aging and regenerative skincare – helping patients achieve radiant, healthy skin from face to fingertips.
As the leaves change, so should your skincare routine. Fall is the perfect time to reset and repair your skin after summer’s sun exposure while preparing it for the colder, drier months ahead. At NicholsMD of Greenwich, our board-certified dermatologist Dr. Kim Nichols and her team of skincare experts share their top dermatologist-approved fall skincare tips to keep your complexion glowing, hydrated, and protected all season long.
As humidity drops, your skin’s moisture barrier needs extra support. Swap lightweight summer gels for richer, barrier-strengthening moisturizers containing hyaluronic acid, ceramides, and peptides. Dr. Nichols recommends integrating SkinCeuticals Triple Lipid Restore 2:4:2 or A.G.E. Interrupter Ultra to help replenish lipids and restore suppleness without feeling heavy.
NicholsMD Tip: Add a hydrating facial or LED therapy session to your routine this season to amplify your skin’s moisture retention and natural glow.
Just because the weather cools doesn’t mean UV damage disappears. Up to 80% of UV rays penetrate through clouds — making daily sunscreen non-negotiable. Opt for a broad-spectrum formula like SkinCeuticals Daily Brightening UV Defense SPF 30 to maintain protection while brightening post-summer discoloration.
NicholsMD Tip: Schedule a professional chemical peel or laser treatment in early fall to target sun damage safely under cooler conditions.
After months of sunscreen and heat exposure, your skin can feel dull or congested. Exfoliating helps boost cell turnover and prep your skin to better absorb hydrating products. Try a gentle glycolic or lactic acid-based exfoliant two to three times a week, or book a medical-grade HydraFacial or dermaplaning treatment for instant radiance.
NicholsMD Tip: Avoid over-exfoliating – your provider can customize the ideal exfoliation level for your skin type and goals.
Fall is prime time to reintroduce retinoids and vitamin C serums if you took a break over summer. These dermatologist-approved actives help repair sun damage, stimulate collagen, and even out skin tone. Our aestheticians often recommend pairing SkinCeuticals C E Ferulic with a nighttime retinol serum for the ultimate fall skin-renewal routine.
NicholsMD Tip: Alternate retinol with a hydrating mask or barrier cream to prevent dryness as temperatures drop.
Fall marks the beginning of laser and resurfacing season – the best time to treat pigmentation, fine lines, and texture. Treatments like Fraxel® Dual Laser, CO₂RE Resurfacing, and microneedling with exosomes deliver long-lasting rejuvenation with minimal downtime. Combined with a customized at-home regimen, these treatments help you enter winter with brighter, stronger, and smoother skin.
NicholsMD Tip: Book a seasonal skin consultation with our team to design a treatment plan that transitions your skin care from summer to winter seamlessly.
At NicholsMD of Greenwich, our skincare experts work alongside Dr. Nichols to deliver personalized, results-driven skincare all year long. Whether you’re refreshing your skincare regimen, repairing post-summer damage, or preparing for colder months, our boutique dermatology practice offers luxury facials, advanced laser treatments, and dermatologist-recommended skincare products to keep your skin healthy and radiant through every season.
Book your consultation today at NicholsMD of Greenwich and discover dermatologist-approved skincare for every season of your life.
At NicholsMD of Greenwich, facial treatments are designed to do more than pamper – they’re scientifically advanced, results-driven experiences that reveal your healthiest, most radiant skin. Combining the precision of medical dermatology with the indulgence of a luxury spa experience, every facial treatment is tailored to your unique complexion, goals, and lifestyle.
Our renowned aesthetician team delivers each treatment with clinical expertise and a personalized touch. As SkinCeuticals Master Aestheticians, our team is recognized for their advanced knowledge in skin science, corrective skincare, and professional facial techniques. Their expertise ensures that every service – from gentle exfoliation to advanced resurfacing – is performed with precision, care, and results in mind.
Together with our full team of licensed skincare professionals, our aestheticians specialize in creating customized facial plans for every skin type and concern. Whether your goal is to refine skin texture, reduce breakouts, or achieve a luminous glow before an event, your skin is in expert hands at NicholsMD.
At our dermatology Boutique, no two facials are the same. Each begins with a detailed consultation and skin analysis to ensure your treatment is completely customized to your needs. Using SkinCeuticals’ clinical-grade products, our aestheticians integrate proven techniques and technologies – including LED light therapy, microcurrent, chemical peels, and oxygen or antioxidant infusions – to enhance your skin’s tone, texture, and vitality.
As an official SkinCeuticals Flagship location, NicholsMD sets the standard for results-driven, luxury skincare. Each facial treatment is designed to not only improve your skin’s immediate appearance but also strengthen its long-term health. Our aesthetic team works closely with Dr. Kim Nichols and our Nurse Practitioners to ensure every patient receives a truly comprehensive skincare experience – combining cosmetic dermatology, medical-grade products, and the art of relaxation.
Located in the heart of downtown Greenwich, NicholsMD offers a full menu of facial treatments that redefine what it means to care for your skin. Whether you’re preparing for an event, maintaining your glow, or addressing a specific concern, our team will craft a personalized plan that delivers visible, lasting results.
Call our office or reserve your appointment online to experience luxury skincare, personalized for you.
