Do jowls make you howl?

For humans, jowls are probably leaders among the “least wanted” facial features. Dog with jowls

On your favorite pooch, they’re cute, endearing, and biologically useful. On most of us? Not cute and not useful.

What are jowls?

Jowls are those extra areas of skin and fat that start appearing in the lower face, as we age. When is that? Well, it varies, but usually starts to become noticeable in middle age; 40s for some, and 50s for others.

Where do jowls come from? They’re parts of your face that respond to the natural effects of aging and gravity. Skin loses elasticity as we age. Facial fat descends along with the looser skin. What was once higher on your cheek, or jaw, now starts to droop below the jawline, changing your facial appearance in a number of ways. Very often, patients will first notice what looks like a little notch between the chin and the jawline. The jaw loses its sharp angle and starts to look like its blending into the neck.

Sometimes jowls are very pronounced, so they’ll look like defined pouches or bags, and sometimes they’ll appear in a more subtle way. It may seem as if there is more weight in the lower face, less definition in the jaw, and the chin may also appear smaller, looser, or pointier.

Again, all of this is normal, and throughout history you can see the age and jowl projection of some of the world’s greatest figures in portraits and sculpture.

Winston Chruchill

Portrait of Winston Churchill

But, that doesn’t mean you need to hang on to your jowls—if you don’t want to.

How can I lose my jowls?

You have some choices. And your best approach will depend on the extent of your own jowl formation. You’ll do best to listen to the advice of your board certified plastic surgeon, and understand that it may not be the solution you want to hear.

Nonsurgical jowl treatment:  If you want to explore the least invasive fixes, Nonsurgical treatments are available, but be aware that they will be effective only in moderate cases.

  • Injections:  Botox and Fillers are frequently used to minimize the appearance of moderate or beginning jowls.  (Those ‘notches’ we mentioned earlier- between the chin and the start of the jaw)  A number of long-lasting fillers can be injected into this area, to restore a straighter jawline, eliminate that notch, and fill in the ‘marionette’ lines appearing from the lip corners down to the chin. Fillers such as Voluma may last up to 2 years, and also encourage collagen production, which may give you an even longer-lasting effect.  Botox injections are used in several areas, to relax muscles in the jaw or neck that may contribute to the jowls’ appearance.  Fillers injected into the cheeks may provide an overall ‘lifted’ appearance to the face, restoring a more youthful shape.
  • Kybella: (Fat-dissolving injections) Kybella injections are used mainly to eliminate fat in moderate double chins. The results can help re-define the chin and jaw area, but will not ‘remove’ jowls. Kybella injections are usually repeated in several sessions.
  • Skin-tightening:  Various machines, including Laser and Radio Frequency. These treatments use various forms of energy to tighten the skin. The results tend to be subtle. These treatments are often combined with injections of fillers to maximize non-surgical ‘lifting.’

Surgical options for jowls  

If you have noticeable sagging, and visible drooping, surgery will be your most effective option.

Facelift before

photo by Dr. Lepore

Facelift after

photo by Dr. Lepore

 Facelift: SMAS Facelift (Superficial Musculoaponeurotic System, involves lifting and repositioning a layer of tissue over the facial muscles).  

Mid-Facelift: MACS Facelift  (Minimal Access Cranial Suspension- involving shorter incisions, used in more moderate sagging and jowling).

Neck Lift: These are the procedures you will be considering. Again, your doctor is best qualified to explain what level of surgical lift you may need to achieve your goals. In each of them, excess skin and fat may be removed, and muscle and tissue will be tightened and restored to a more youthful position. Liposuction may also be part of the surgery.

Implants: Many patients choose to have surgical implants placed in the chin, and/or jawline to give them the defined look they desire.

Can I do anything to avoid jowls?

Some basic lifestyle habits can certainly help maintain what you have; such as, avoiding large weight fluctuations, protecting your skin with sunscreen and moisturizers, not smoking or over-indulging in alcohol, etc. Your own facial structure, combined with genetic predisposition and natural aging, will be the main factors in determining the changes to your appearance.

But, remember, you have many options should you choose to lose your jowls.

[Board-certified plastic surgeon Dr. Vincent Lepore offers a full range of cosmetic surgery and noninvasive treatments in his conveniently-located San Jose office and surgery center. Please call to schedule your free cosmetic consultation at (408) 356-4241.]


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