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It's an inevitable truth that our skin changes with age. Apart from developing fine lines and wrinkles, our skin also loses collagen which leads to overall sagging. One of the most prominent places we can see this in the jowls, but thankfully there are more than a handful of treatments that can help prevent them from developing prematurely and can treat them once they do.
The jowls are located along the jawline, and when they form they reduce the appearance of jaw definition and, in some cases, create the illusion of a double chin. Of course, there's nothing wrong with any of this, but we understand that some people may prefer to restore their tightness for a more youthful appearance.
That's where we come in. We tapped two board-certified dermatologists and three plastic surgeons and asked them what the best ways to prevent and treat jowls is. From using skincare products with youth-preserving ingredients (such as retinol and peptides) to minimally invasive treatments (such as Botox and fillers) and surgical options (like face lifts), keep scrolling to learn all the ways you can treat jowls.
Meet the Expert
- David Shafer, MD, is a double board-certified plastic surgeon based in New York City.
- Michele Green, MD, is a board-certified dermatologist in New York City.
- Sam Rizk, MD, is a facial plastic surgeon based in New York City
- Theda C. Kontis, MD, is a facial plastic surgeon & Immediate Past President of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS)
- Doris Day, MD, is a board-certified dermatologist in Manhattan.
What are Jowls?
Before we jump into the subject even further, let's get our definitions right. "Jowls are the areas of soft tissue fullness that appear along the jawline as we age," explains Kontis.
What Causes Loss of Elasticity in the Jowls?
One of the most common reasons we lose elasticity in the jowls is aging. While a loss of elasticity can start happening in your late 20s depending on your genetics, Shafer says that it’s especially common in late 30s to early 40s patients. “This is most often when patients start looking in the mirror and noticing that their skin is not as ‘tight,’” he explains. However, Kontis says jowls typically from in the 50s to 60s range.
Not sure if you’re losing elasticity? Shafer has a way to help you find out.“If you pull on the skin and it snaps right back there is good electricity,” he shares. “However, if you pull on the skin and it slowly recoils then the elastic properties of the skin are diminishing.”
Even if your face or other areas of your body bounce back rather quickly, your jowls (which refers to the area below your jaw leading into your neck) might not fare as well. That’s because, according to Green, the skin around your neck is thinner than most parts of the body, therefore, loses its elasticity sooner. As a result, she says that sagging, crepiness, and signs of tech neck are likely to appear in your jowl region before you notice changes on your face. “Your neck also has a different collagen content making it particularly prone to the wear and tear of aging,” she adds.
Outside of aging, Shafer says that extreme weight gain and loss can also play a role. “Think about a balloon,” he says. “If you blow it up and let the air out the elastic shrinks down. But if you blow it up and let the air out several times, the balloon loses its elasticity.”
Furthermore, Day explains that jowls can happen as a function of the jawbone shrinking, the chin receding, loss of fat and collagen, and/or the shifting of fat pads
Another thing that can impact loss of elasticity in the jowls? Smoking—as if it weren’t already bad enough. “Smoking is the number-one thing you can stop to improve your skin,” Shafer says.
Now that you know the main reasons for jowls, let’s go over how to prevent and treat them.
Expert-Recommended Jowls Treatments
Consider CoolSculpting
On the opposite end of the spectrum, Shafer recommends CoolSculpting. “For people who have submental and submandibular fullness and jowling—often referred to as a double-chin—we recommend a CoolSculpting treatment to freeze the fat, which destroys the underlying fat,” he shares. “As the fat is reabsorbed into the body the skin contracts and may tighten, which is an observation from the clinical trials.”
Opt for Skin Tightening With Thermage
If injections aren’t your thing, consider radiofrequency. “Thermage is the gold standard for non-invasive skin tightening,” Green says. “It addresses the early signs of aging such as superficial fine lines, wrinkles, sagging jowls, crows feet, cellulite, and loss of skin laxity.” What’s more, it’s non-invasive.
“Thermage (RF) technology delivers heat deep into the epidermis, dermis, and subcutaneous (fat layer) layers of the skin,” Green explains. “It is the tightening of these layers of skin which produces the smoother skin texture and defined contour. There is no downtime and you can return to all your normal activities right after treatment. Results may appear immediately after treatment with improvements continuing in two to four months."
Look Into Kybella
Kybella injections are the most popular—and most direct—jowl treatment. “The presence of submental fullness in the jowl is a common concern that affects both women and men,” Green explains. “In the past, the only way to permanently enhance the jowl was through surgical procedures such as liposuction or a neck lift which required anesthesia, incisions and lengthy recovery periods.” Thankfully, now Kybella exists. “Kybella is the first-of-its-kind injectable treatment that melts away fat cells to offer long-lasting improvements to your appearance,” Green explains. "The active ingredient in this injectable is deoxycholic acid which is a naturally-occurring substance that destroys fat cells permanently," Green says. The best news? Green says that as little as a few treatments of Kybella can help trim down jowls and create a more defined jawline and profile.
Get a Chin Implant
While a chin implant isn't designed to treat jowls, Kontis says "a certain type of chin implant that has fullness in the area in front of the jowl can camouflage it."
Get Sofwave Treatments
Sofwave is a minimally invasive treatment that uses ultrasound technology to stimulate collagen production and tighten tissue, and Day swears by it. "This is a staple of my treatments for jowls. Patients love the results and there is little to no downtime," she shares "We usually do one to three sessions at three-month intervals and then maintenance treatments once every 10 months."
Rizk seconds this treatment as a go-to solution for jowls. "It was FDA-cleared two years ago, but holds some promise in lifting not only jowls but also eyebrows, neck tissue, and lax skin under the chin," he says.
Book a PRP Treatment
Platelet-rich plasma treatments are another option because, as Shafer points out, they concentrate growth factors from your blood directly into your skin, which can promote firmness and suppleness, minimizing the appearance of jowls.
Consider a Nefertiti Lift
Another option is to get creative with Botox. While the injectable is widely used for addressing crow’s feet and forehead wrinkles, Green says that it can be beneficial for the neck and jowl area, as well.
“Botox injections can be used to help reduce the look of bands across the neck,” she explains. “As you get older the main muscle in the neck, the platysma muscle, can look as though it is separated, creating two vertical bands up and down your neck. Botox injections into the muscle helps it relax, reducing the appearance of the bands. Botox can be injected into the platysmal bands across the neck to lift the lines and wrinkles giving the neck a more youthful appearance—this is also referred to as the Nefertiti Lift.”
This lift is a non-invasive option for those looking to restore contour to the neck and jaw, Green says.
“The treatment is two parts,” she explains. “The first part consists of injections of Botox across the platysma muscles and jawline. The Botox causes the muscles of under the jaw to relax which causes an upward pulling of the facial muscles reducing the sagging jowls. The second step in the treatment is injecting dermal fillers along the jawline to increase the volume further correcting any sagging.
Opt for Products Formulated With Hyaluronic Acid
Shafer says that one of the most essential ingredients for promoting skin elasticity is hyaluronic acid, which naturally occurs in the body and is known to hold up to 1,000 times its weight in water. As such, he recommends using products—especially neck creams when it comes to the formation and reduction of jowls—formulated with the hydrating and plumping ingredient.
Approach Elasticity Loss From a Metabolic Level
Shafer reminds us that elasticity can be addressed from the inside out, as well. Where he offers hormone balancing in the Metabolic Aesthetics Center at Shafer Clinic Fifth Avenue, another option is to add a collagen supplement to your routine. One study found that participants who consumed collagen supplements regularly noticed significant improvements in skin elasticity.
Schedule a Laser Treatment
Another in-office treatment revolves around lasers. “For people who have slight jowling, there are many non-surgical options like energy-based treatments—Fraxel, picosecond, and IPL—to stimulate skin and induce collagen and elastin production,” Shafer says.
Take It a Step Further With Fillers
Shafer says that hyaluronic acid fillers can help provide a more defined chin and jawline, taking away from the appearance of jowls. The biggest thing to note is that, like all in-office treatments, you want to do your due-diligence so as to go somewhere reputable.
Try Radiofrequency Treatments
If you're looking for another minimally invasive treatment, then you should try radiofrequency. Radiofrequency uses waves of energy to heat up the deeper layers of skin, and in turn, increasing collagen production and tightening any loose skin. The best part? It's a super quick and easy procedure (hello, lunch break!), and has minimal downtime.
If You Want the Fastest Solution—Consider Liposuction or a Face Lift
If nothing else works, or if you simply want a faster solution for your sagging jowls, Shafer says liposuction is on the table. “As a plastic surgeon, it would be remiss if I didn’t [mention] liposuction and facelift surgery,” he says. “I perform a lot of facelifts in our surgical sky suite at Shafer Clinic. Facelift is surgical and involves lifting the skin of the neck and cheeks and tightening the underlying muscles and then gently repositioning and smoothing the skin and removing any excess skin. This is the most effective and beneficial treatment for people who have a lot of excess skin.”
Look to Ultrasound Therapy
Ultrasound therapy, or Ultherapy for short, is another great option for addressing sagging jowls. Similar to radiofrequency treatments, ultherapy harnesses the power of ultrasound to deliver heat to the deeper levels of the skin to stimulate collagen and elastin. The best thing about ultherapy is you usually only need one treatment to see major results. Studies have shown that nearly 70 percent of people saw improved results up to three months after the treatment.
Get Morpheus8
Combining a radiofrequency and microneedling treatment like Morpheus8 isn't a solution for fully-formed jowls, but Kontis says it could potentially help very early jowls in younger patients.
Use Sunscreen Every Day
Sunscreen is single-handedly the most effective anti-aging ingredient on the market. You need to wear sunscreen every day to prevent harmful UV rays from breaking down collagen and accelerating visible signs of aging. "This sounds so simple, but it is crucial. I always advise my patients to wear a physical sunblock, even when they’re not outside. Glass blocks UVB rays, which cause sunburn, but UVA rays can still get through. These rays are responsible for breaking down collagen and elastin and accelerating the aging process and disrupting our skin’s DNA and causing the mutations that lead to cancer. We’re getting that exposure when we’re driving, sitting next to a window during a meeting—the list goes on," explains Rizk. "If sunscreen isn’t a part of your daily routine, start now."
Add Vitamin A or Retinol Derivatives to Your Routine
Retinol for aging? Groundbreaking, we know. But hey, it works! “Retinol is a vitamin A derivative best known for its ability to neutralize free radicals, stimulate collagen production, and facilitate cell turnover, therefore smoothing fine lines and wrinkles,” Green explains, noting that it’s the gold standard of anti-aging and works best at night to improve the tone and texture of the neck—meaning it’s a shoo-in for jowl treatment.
Cozy Up to Products Infused With Collagen Peptides
Where collagen is a protein that’s responsible for the skin’s firmness and suppleness, Green reminds us that peptides work to stimulate collagen production. As such, collagen peptides are a no-brainer for jowl prevention.
Make Room for Vitamin C in Your Routine
As one of the most powerful antioxidants, Green says that vitamin C helps fight free radical damage (which is known to accelerate aging), while also boosting collagen production, making it a must for a preventative anti-jowl routine. Dermatologists recommend adding a vitamin C serum to your routine every morning.
