Options to Address Jowls without Using Fillers?

Simple question. How can I lift my pre-jowls? I'm 35, good skin, have had radiesse in the past and happy with the amount of volume on my face. BUT my jowls are a little saggy. I don't want to add fillers. I have sustained my V shape face by rejecting fillers in the jaw. Is surgery the only way to lift my small jowls? Thanks!

Doctor Answers 17

Jowls and Non Surgical Facelift

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  • Dear Ling Ling,
  • Depending on your exam, a little in office, hand assisted liposuction may help you get the results you are looking for
  • Other options include some fillers above the jowl or cheek to lift up tissues
  • A mini facelift is another option
  • Your treatment all depends on what you look like

Best regards,

Nima Shemirani

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Fillers are for filling

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Your question is a good one. With the advent of safe and effective fillers its tempting for physicians and patients to use fillers in areas where they may not be ideal. Fillers are great for augmenting areas that don't have enough volume like the cheeks or the lips. When used in the jowl area they don't really treat the underlying problem.The jawline skin and underlying muscle are falling and need to be tightened. A small incision around the earlobe can be used to access the SMAS layer and pull the jawline tissues tightly. This is probably a better solution than trying to camouflage the problem with a filler. In your case you may be a little young to consider surgery just yet so proceed slowly.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 reviews

Options to Address Jowls without Using Fillers?

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 If your jowls are a certain size, or depth, then a minimal incision face Lift that dissects the SMAS and emoves skin is the best solution IMHO. If however, the jowls are quite small..you could try a tightening treatment like Thermage or Ulthera.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

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Ultherapy for a non-surgical jowl lift

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I use the Ulthera system to improve jowls on the lower face without surgery or incisions. Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Can I get rid of my jowls without fillers?

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Based on your age and description of your concerns, I would recommend one of a few options. Certainly filling the pre-jowl area will help mask jowl sagging. Other options include laser lipolysis of the jowls, surface skin tightening devices such as Exilis and Ultherapy or a "mini" face lift.

Carey Nease, MD
Chattanooga Facial Plastic Surgeon
4.1 out of 5 stars 24 reviews

Ultherapy: A Non-Surgical Facelift that Works

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At your age, Ultherapy may well be your best option. It’s a one-time, non-surgical treatment that achieves dramatic results, especially among patients whose skin cells are still resilient and collagen-producing. The treatment is used to lift, tone and tighten the face. Furthermore, it has been proven particularly effective when treating lax, sagging skin in the area of the brow, cheeks, jowls, chin, and neck. The 60-to-90-minute procedure involves no incisions or downtime, nevertheless the ultrasound technology targets tissue deep below the skin’s surface to promote collagen production in the same way plastic surgery does. It is a painless protocol that delivers significant results within three weeks, and those results continue to improve dramatically for up to three months.

Hal Michael Bass, MD
Miami Plastic Surgeon

Surgery is the best option

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A SMAS based lower facelift is always the best way to lift the prejowls.  If a surgeon is working on just this part of the face, a more limited incision can be used, similar to a mini facelift incision.


Another option we have been using with good results has been to use the Cynosure Sidelaze to tighten the face and neck skin.  This relatively new treatment uses only laser energy to help tighten this area.  The results are not as good as formal lifting of the face, but you could consider this option before a facelift.



Shim Ching, MD
Honolulu Plastic Surgeon
4.6 out of 5 stars 51 reviews

Jowling at Early Age

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This can be a more complex issue. For a younger patient, when jowling is noticeable, a facelift is not always the answer. Fillers can serve to restore a smoother contour on a temporary basis. Often however, this can be a bony structure issues. A "weak" chin (one that is set back more than usual) can cause the cheeks to look like they are sagging. Chin or "pre-jowl" implants can restore that strong, smooth and full jawline and stretch out the jowls that seem to be there. Non-invasive tightening procedures, like Ulthera, can also help. If your cheek bones aren't full or high enough, that will also make jowls more noticeable. So, a full exam of your facial structure in all 3 dimensions is something to discuss with your Facial Plastic Surgeon.

Manu Gujrati, MD
Palo Alto Facial Plastic Surgeon

Several options for early jowls exist

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For very small pre jowl sags, fillers do straighten the jawline.They are fast, virtually painless, inexpensive, and last about a year.

Devices such as thermage or ultherapy work by stimulating deep collagen in the area. There is more pain, and more expense, but usually longer results.

Finally,- a small surgical lift can tighten the muscle and skin. This typically would involve slightly more downtime, pain, and cost. but last the longest. 

Each person's situation is unique, so there is no right answer for everyone.


Christopher J. Peers, MD
South Bend Facial Plastic Surgeon

Jowls and Pre-Jowl Treatment Options

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Jowls and Pre-Jowl Concerns can be addressed without fillers by minimally invasive surgical techniques. You have not provided photos so the following are general recommendations that might apply to you. For example if jowls are a problem and it is mostly a fat issue (rather than skin redundancy) then liposuction using a very tiny cannula is helpful. Likewise fat transfer (for example from the Jowls, below the chin or from the tummy) can be used to fill in the slight hollowing in the pre-jowl area (the depression between the chin and the jowl). If loose skin is an issue then a mini-facelift such as a Lite Lift, MACS, etc is helpful.. 


These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.