Jowls

Jowl Treatments, At A Glance

  • Best Results1-3 sessions
  • Treatment RecoveryImmediate
  • Procedure Time20-40 minutes
  • Skin SpecialistNurse injector, dermatologist
  • Duration of Results2-4 years
  • AnaestheticNil required
  • Back to Work Immediately
  • Cost$$-$$$

Jowls

The term “jowls” refers to sagging skin between the jawline & the corner of the mouth. Everyone develops jowls with maturity. It happens because your skin becomes thinner and less elastic over time. Additionally, there is bone resorption of the jawline that can worsen jowling. Fillers can provide volume replacement to the area, whilst energy-based devices can potentially tighten loose skin. In mild to moderate cases of jowls, mono or suspension threads may provide a short term solution.

FactsFacts on treating Jowls

  • Jowling is due to loss of elasticity & skin support, including bone resorption
  • Treatments are aimed at increasing elastin, collagen & hyaluronic acid
  • Dermal fillers help support the skin by replacing loss volume
  • Hyaluronic acid & collagen stimulating fillers are most widely used
  • Laser resurfacing can improve skin quality with collagen contraction
  • Thermage, Tempsure, Pelleve & Ultherapy can increase collagen production
  • Surgical approaches are best for severe jowls
  • Combination fillers, threads & energy devices can treat mild to moderate cases

What causes jowls?

Advancing age, genetics, environmental factors & weight loss all contribute to jowls.

Age. With this comes a decline in the supporting structures of the skin, namely collagen & elastic fibres. Importantly loss of bone occurs in the early 40s, leading to shrinking of the jawbone (mandible). Treatments such as dermal fillers, lasers & heating devices target this cause & rebuilds new collagen.

Genetics. Patients who have genetically thicker bundles of collagen tend to age less.

Environmental factors such as UV, smoking & pollution can contribute to jowl lines. Avoiding these triggers can reduce ageing & improve the quality of your collagen.

Weight loss. When you gain weight, skin stretches. Conversely rapid weight loss can lead to sagging of the overlying skin, giving rise to jowls.

How do you get rid of jowl lines?

There are many options for treating sagging jowls or reducing how saggy or droopy they appear. Nonsurgical procedures, such as radiofrequency, lasers, & peels, can change the composition of the collagen. Dermal fillers can be used to camouflage hollow areas around the jowls. Thread lifting is a temporary procedure that can improve mild to moderate cases of sagging & jowls.

Surgical procedures, including, face & neck lifts, can tighten your skin and make it look less saggy.

How can fillers improve jowls?

Fillers can help decrease jowls by displacing volume & providing counter traction with vectors. Sounds complex? It’s actually an easy concept to understand. Place your finger a point just below the earlobe. Now gently push back & upwards. Creation of a new jawline angle can help reduce jowls in most patients.

Another displacement vector is the cheekbone. Volume displacement can create lift. Another method is to create new lines from the angle of the jaw to the jowls, taking care NOT to add volume to the jowls. It’s all about smooth transitions & transformations. In the majority of cases, strategic use of collagen stimulating fillers can give a good improvement to the jowls.

Can lasers help tighten skin?

Lasers target the upper layers of the skin, improving skin quality & textural changes such as sun damage, pigmentation & wrinkles. Ablative laser resurfacing will also contract & stimulate collagen, indirectly improving the appearance of mild to moderate jowls. Severe jowls will not ‘lift’ with lasers nor energy devices.

If skin quality is good, lasers are not advisable. There are far more efficient & cost-effective ways to treat jowls without associated downtime. Dermal fillers can initiate collagen stimulation whilst gentle radiofrequency (see below) can effectively tighten skin.

Davin’s take on treating jowls

Probably the number one area of concern for patients in their 40s to 50s. In most there are multiple issues including age related laxity as well as bone & fat loss. In some cases, it is increased heaviness of facial fat that contributes to jowls. Elastosis or collagen breakdown due to UV & smoking is another common cause. Treatment will depend on the contributing factors.

Injectables including dermal fillers form the mainstay of treatment. My go to filler is calcium hydroxyl apatite. This builds up the jawline area & provides traction to support the skin. Chin augmentation also provides traction, whist fillers on the cheek bone can decrease downward descent of the cheek. There is no one cookie cutter treatment modality for jowls. In some patients, dermal fillers can be used, in others, tissue tightening with devices. In severe cases, either a mini-s face lift or a deep plane lift is best. Careful examination to determine the cause/s of jowls will dictate the best treatment/s. The majority will benefit from a combination approach.

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