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As people age, there are natural changes that occur in the shape of the face. This is due to a number of factors, including a loss of elasticity in the skin, reduced muscle tone and the subsequent ‘sagging’ of the natural fat pads within the face that help to give the face its natural shape and contour. The term ‘jowls’ is used to refer specifically to loose pockets of skin around the jawline.

Jowls are commonly formed from the fat pads from the cheeks that have dropped over time, in combination with saggy skin. This is often seen in combination with a ‘double chin’, which refers to additional pockets of fat underneath the jaw itself. Jowls most commonly occur in individuals over the age of 40 and are seen more often in women.

Unfortunately, the presence of jowls can lead to loss of definition around the jawline which can cause some individuals feel particularly self-conscious and uncomfortable. There are a number of measures, including cosmetic procedures, that can be used to treat and improve the appearance of jowls, depending on their severity.

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About this condition

A major factor in the development of jowls is the change in skin elasticity associated with increased age. As the skin itself ages, there is a reduction in the amount of special connective tissues produced, such as collagen and elastin. These connective tissues are what make the skin elastic and able to hold a smooth and plump contour. If there is less collagen and elastin within the skin, the skin is less able to retain its original shape, particularly in areas where the underlying muscles are very active. This can lead to skin that develops lines/wrinkles and appears looser and saggy. When this occurs around the lower face and jawline, it can lead to the formation of jowls. In addition to age, there are a number of other risk factors associated with the development of jowls:

  • Family history of jowls (genetics can play a role)
  • Chronic dehydration or poor diet and nutrition
  • Smoking
  • Chronic sun exposure
  • Rapid or extreme changes in weight, which can lead to a redistribution of the natural fat pockets around the face
  • Skin exposure to harsh chemicals or pollutants
  • Previous injury or trauma to the lower face or jaw

There are a number of measures that can be taken to prevent or treat jowls. Modifying any of the risk factors listed above, such as improving hydration and nutrition, smoking cessation, ensuring adequate sun protection and good general skin care can all be helpful in maintaining youthful looking skin. There is a range of options available for those who wish to seek more definitive or immediate treatment for jowls.

Filler injections can be targeted around the mid and lower face to help increase the volume around the cheeks and give a more ‘lifted’ appearance. Laser treatments can also be utilised and work by targeting layers of the skin to produce more collagen. This can help the overlying skin to appear smoother and rejuvenated. In particular, Endolift treatments are a good laser-based option for the treatment of jowls as this also targets the underlying fat pockets. Both filler injections and laser-based techniques are non-surgical, so are less invasive and can be delivered within an outpatient appointment. However, they may require repeated rounds of treatment to give long lasting effects.

Surgical procedures such as a face lift or liposuction can be used to reduce the appearance of jowls and restore a more youthful proportion and defined contour to the jawline. These are more invasive procedures and will involve either a general anaesthetic or a local anaesthetic with sedation, however are more likely to give impactful and long-lasting results.

Mr Ioannis Goutos is an expert plastic surgeon with clinics based in London. He offers a wide array of surgical and non-surgical procedures for cosmetic problems and places particular emphasis on creating holistic and tailored treatment plans for each individual.

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