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Apart from fine lines and wrinkles, another skin concern many have when getting older are the appearance of jowls. If you’re not familiar, jowls refer to the loose, sagging skin around and/or below your jawline. Board-certified dermatologist at MDCS Dermatology Marisa Garshick, MD, says that people often start to notice jowls in their 40s, but they do become more noticeable when people approach their 50s and 60s.
Many things can cause jowls — the first being age. “As we age and lose collagen and elastin, there is increased skin laxity which can contribute to jowls,” says Dr. Garshick. “Additionally, bone resorption that happens along the cheekbones and jawline can make jowls more prominent. Any factors that can accelerate the skin aging process or impact collagen production can contribute [to the formation of jowls].”
Next is genetics. Board-Certified Plastic Surgeon at the New York Plastic Surgical Group, Jerry W. Chang, MD, FACS, explains that your genetics affect the elasticity of the skin and its support system. So while it’s most common for you to experience jowls at later stages of life, your genetics can make it so you notice them earlier. Other factors he lists include smoking, sun damage, and massive and quick weight loss (he points to weight loss surgery and treatments such as Ozempic can often result in fast tissue loss and cause that droopiness).
Double board-certified plastic surgeon at the Shafer Clinic Fifth Avenue, David Shafer, MD, FACS, adds that anyone is prone to jowls, but genetics and face shape play major roles in who is more likely to get them. “If you have a fuller face, you may be more prone to jowls,” he says. “Jowls tend to be more prevalent in women as opposed to men, but the age range remains the same for both.”
If you’re not sure if you’re losing elasticity in your skin, Dr. Shafer suggests gently pulling on the skin below your chin to see how it reacts. He says if it snaps back into place quickly, you still have elasticity in that area and have not developed jowls. If the skin takes a long time to bounce back into place, that means that the elastic properties in that area are decreasing.
Another sign that you might have jowls includes the obvious appearance of sagging below the jawline. Dr. Chang says that when you look at your jawline, there should be a sharp straight line from the chin to the angle of the jaw. Jowls, he explains, happen when that sharp line is disrupted and the skin droops beneath it.
So, if you’re looking for ways to treat jowls and get a more sculpted look in the jawline area, you’re in luck. There are plenty of treatments you can try. See the best ones below.
1. At-home treatments
You can try using products with known anti-aging properties — Dr. Garshick says that retinoids are the gold standard and they can help stimulate collagen production. Other ingredients to consider include peptides or growth factors, which she says not only support collagen and elastin but they firm and tighten the skin. She recommends products like the Olay Regenerist Microsculpting Cream and the Alastin Restorative Skin Complex. You’ll also want to wear sunscreen to protect skin from UV damage.
Dr. Shafer would recommend products with hyaluronic acid, which he says will help promote skin elasticity, and adding vitamins C and A to help protect the skin from environmental agressors. When applying to your face, he says that it is important that you put product on your neck and the space below your chin for maximum results.
2. Fillers and injectables
If you’re looking for a stronger approach to treating jowls, there are plenty of aesthetic treatments you can try. Dr. Garshick says that placing filler along the jawline will contour and improve the appearance of jowls. “By injecting filler in the pre-jowl sulcus (or the area in front of the jowls), it can make jowls appear less noticeable,” she says. “Injecting towards the back of the jawline may provide structural support to the jawline to give the appearance of a more lifted and contoured jawline.”
Dr. Shafer recommends Juvederm Volux, which is the first FDA-approved hyaluronic acid-based filler for jawline enhancement. You can also opt for Voluma off-label or Restylane for jawline enhancement.
Other injectable options include Sculptra, which Dr. Chang describes as a poly-L-lactic acid collagen stimulator that helps restore the underlying structure of the skin, and Botox, which Dr. Shafer says helps freeze neck lines to get you smooth and tighter skin. He also points to Kybella, which not only treats the chin area but can also sculpt the jawline.
3. Facial liposuction
For a surgical procedure, Dr. Chang says that liposuction can be performed when treating jowls. You’ll have to keep in mind that this is a suitable option for mild cases and he says it won’t work well for those with very loose skin.
4. Radiofrequency, ultrasound, and other energy-based devices
For the non-invasive approach, all three experts suggest looking for energy-based devices to improve the appearance of jowls. Dr. Garshick lists radiofrequency microneedling to stimulate collagen production and tighten the skin and Inmode Evoke, which uses radio frequency to change the shape of muscles for a tighter appearance.
She also recommends Facetite, which combines radiofrequency and liposuction to eliminate fat while also tightening the skin and ultrasound technologies like Ultherapy which uses ultrasound energy to tighten loose skin and support collagen production.
Dr. Chang recommends Morpheus8, which is a fractional radiofrequency microneedling treatment. Dr. Shafer likes the Lumenis NuEra Tight, which delivers heat energy to layers of the skin, and EMFACE, which heats up the dermis while also selectively contracting muscles to increase density and result in a natural lift.
5. Face or neck lifts
Dr. Shafer says that one of the most common procedures for reducing the appearance of jowls is a facelift. He explains that this surgery works by lifting the skin of the neck and cheeks which tighten the muscles underneath and reposition the skin after the muscles have been tightened.
“Surgery such as the mini facelift or full facelift remains the only modality to treat prominent and severe jowling,” adds Dr. Chang. It addresses all three components of the causes of jowling and can last 10-15 years.”
So, there are many options for you if you’re looking to treat jowls. But as with any skin concern, you’ll want to carefully do your own research and consult with a professional to see what the best treatment plan is for you. “Ultimately it depends on how severe the jowls are, as some treatments may not be as helpful depending on the severity so it is important to be realistic about expectations,” says Dr. Garshick. “It also is important to consider if the individual wants to take a surgical or non-surgical approach and the downtime someone has. That said, we’ve had many new devices and treatments recently become available, providing us with more options to find something that works for everyone.”
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