Sagging Jowls: Causes and Treatment Options

Sagging Jowls: Causes and Treatment Options

Jowls describe loss of definition or downward change along the lower cheeks and jawline. They are a common part of ageing and can reflect changes in skin elasticity, facial fat, ligaments, muscle and bone support. Inherited anatomy, ultraviolet exposure, smoking and weight change can affect the pattern. A photograph alone cannot show which structure contributes most.

There is no single best treatment

The appropriate option depends on the degree and cause of the change, general health, medicines, skin, previous procedures, expectations and tolerance for recovery and risk. Skincare may help surface dryness or further sun damage, but it cannot reposition deeper tissue or remove substantial loose skin. A consultation may lead to a procedure, surgical advice or no treatment.

Dermal filler

A clinician may consider a suitable dermal filler when volume or structural support contributes to the lower-face pattern. It does not tighten loose skin and is not appropriate for every jawline. Results and duration vary. Swelling, bruising, pain, redness, lumps, infection and delayed inflammation can occur. Rare accidental injection into a blood vessel can cause tissue death, visual loss or stroke and needs urgent assessment.

Energy-based procedures

Ultrasound, radiofrequency and other energy-based procedures differ by device, depth and settings. Any change may be limited and is not equivalent to a surgical lift. Possible harms include pain, redness, swelling, burns, pigment change, scarring, fat loss and nerve injury. The US FDA has reported serious complications with some uses of radiofrequency microneedling, so ask for the exact device, indication and operator experience.

Surgical options

A facelift or neck lift may reduce marked loose skin around the lower face and neck. It is surgery with scars and recovery, and results are not guaranteed. Risks include bleeding, infection, blood clots, anaesthetic reaction, poor healing, asymmetry, altered sensation, nerve injury and hair loss around scars. The surgeon should explain likely benefit, limitations, aftercare and how complications would be managed.

Choosing safely

Ask what is creating the jawline change, who will perform the proposed procedure, the exact product or device, realistic degree and duration of benefit, alternatives, material risks, recovery and the plan for complications. Take time to decide. No procedure can stop normal ageing, and a suitable assessment may conclude that no procedure is appropriate.

Scope of this article

Dr Sknn is an independent private aesthetics and cosmetics clinic. This page is limited to cosmetic concerns and treatment considerations. Suitability, risks, recovery and current availability are confirmed during an individual consultation. New, changing or unexplained symptoms should be assessed by an appropriate healthcare professional before cosmetic treatment.