Everyone hates their jowls. Other than changes around the eyes, the development of jowls is the most common complaint that people have regarding the aging face. What are jowls? When the skin and fat in the lower cheek become loose and begin to obscure or hang over the jawline, that is jowling. Most people develop those changes in the lower cheeks before they develop excess skin in the neck. There are some people where the neck changes occur first, but they are in the minority.
When people in their 40s or older consult a plastic surgeon, the laxity in the lower cheeks is almost always a complaint. And when people do decide to have a facelift, they almost always say their number one goal is eliminating the jowls!
What causes jowls
Gravity
As we age, the skin and fat in the face begin to loosen and sag. There is a point just in front of the jowls called the mandibular ligament where the skin is fixed to the bone and sagging doesn’t occur. This allows the sagging to happen just behind that point and hence the development of jowls.
Genetics
The development and severity of jowls are also influenced by your genes. If one or both of your parents developed them, there is a great likelihood that you may also develop jowls. Also, if you and your family have naturally thin skin or have a small amount of elastin and collagen in the face and neck areas, you may develop jowls earlier in life. The bigger the cheekbones and the stronger the lower jaw, the less likely you are to develop jowls early…but you may not escape forever.
Lifestyle choices
Genetics is probably more important than lifestyle in jowl development but obesity followed by massive weight loss certainly contributes to jowls. Smoking may also contribute.
Environmental factors
The obvious environmental factor is sun exposure which speeds up the deterioration of the skin with age.
How to get rid of jowls
Exercise won’t work, unfortunately.
Exercise
Exercise strengthens muscles but it does not strengthen skin and fat. In the same way, that exercise, which helps us in many other ways, will not tighten sagging, stretch-marked abdominal skin, exercise will not lift or improve the jowls.
Non-surgical treatments
While the media may suggest that injecting fillers in the upper face will “lift” the jowls, the benefit, if it exists at all, is very limited. The same is true for other less invasive treatments that use ultrasound or radiofrequency to tighten the skin. Liposuction alone will usually make the skin laxity worse so as an isolated treatment, liposuction is probably not beneficial in the vast majority of cases. There is really only one treatment for jowls and that is surgical, as detailed below.
Surgical treatments
The gold standard and really the only way to treat jowls effectively is with a cheek lift (facelift) during which the surgeon may remove some of the fat directly, in addition to lifting the cheek back up into the face.
Recovery will probably take 2 weeks depending on the type of lift that is performed. If combined with a neck lift, then it will be 3 weeks before you can return to full activity and your normal exercise regimen.
Consult a Plastic Surgeon.
A board-certified plastic surgeon will advise you regarding the pros and cons of surgical cheek lifting in your case.
If your jowls and sagging jawline are starting to bother you, consult a surgeon with years of experience. Dr. Charles Thorne has more than 30 years of experience in performing plastic surgery and uses the appropriate procedure to produce maximal and consistent results for each individual patient. He would be happy to answer your questions and care for you. Schedule an appointment here.
Dr. Thorne is the Editor-in-Chief and the author of several chapters in Grabb and Smith's PLASTIC SURGERY, 7th Edition.