Jowls Are Starting to Appear, What Are The Best Options?

Which is better, a lower face lift or will something like restylane or juvederm work better?

Doctor Answers 15

Fillers for early jowling

There is a period of time between when the dreaded jowls start to show up and the time when surgery is warranted.

During that time, fillers such as Juvederm placed carefully along the jawline and in areas of hollowness in the face can go a long way.

Minimally invasive treatments such as fractionated laser, radiofrequency tightening procedures, chemical peels can all help.

Regular skin care and microdermabrasion treatments and a retinoid if appropriate are also helpful.

Patients should maintain optimal physical fitness to avoid excessive jowling that comes with frequent yo yo weight gain/loss patterns.

Patients should also avoid sun exposure and cigarette smoking, but I am nagging.

Minilifts should be carefully considered. As you can see from the posts, minilifts are not minimally invasive procedures that lower trained doctors do as an alternative to traditional facelift surgery. They are in fact real surgery. They leave real scars. They cause real pain. Minilifts performed on younger patients need to have an exceptional skill level to avoid detection. They should be performed by surgeons skilled in and experienced with full facelift surgery.

Even doing that facelift eventually doesn't mean the patient will no longer require maintenance; this will still be necessary for the patient who will not go down without fighting.

People who look absolutely fantastic for their age usually do many of the things above.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 178 reviews

Jowls or Marionettes?

As we age our skin becomes thinner and less elastic. Gravity adds a downward and, due to anatomy, a slightly medial or pull toward the center of the face. These are the reasons that we begin to see accentuation of the nasolabail folds and the start of the marionette line (the continuation of the nasolabial folds below the mouth) in our late thirties and early forties. In addition as the deep facial tissues descend the jowls appear.

This is a great time to attack the aging process head on. If you're not on Retin-A and a good skin care program you need to get started. To address the marionettes and the nasolabial folds fillers are great. Radiesse is great for the depression between the jowl and the chin as well as the marionettes and nasolabial folds at the nasal junction. Other fillers can be added as well.

Significant jowling will likely require surgery to both remove some fat and to resuspend the deep tissues.

So interview several surgeons and find the one that you connect with. Be sure your surgeon discusses all of these issues .

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 34 reviews

Juvederm and Restylane fill lines, they don't take away jowls

With the plethora of new technologies in medicine, it is very easy to get confused with what injectables can and cannot do.

Botox is a neurotoxin that paralyzes muscles. It is generally used by plastic surgeons to paralyze muscles in the face, and softens the wrinkles associated with overuse of these muscles.

Restylane and Juvederm, on the other hand, are synthetic fillers. They are used under the skin to fill natural lines, or to plump up areas. The most common areas of use are in the nasolabial folds or "smile lines" and in the lips.

What we call "jowls" are actually the natually aging process of gravity, where the cheek begins to descend in to the neck. I am sure there are people out there who believe that injecting something, or even performing liposuction alone, can remedy this problem, I personally believe that this is not the case.

A short scar or "mini" facelift can help lift the cheek back to its youthful position. I can understand that since you're only in your 30's, the idea of a facelift seems rather extreme. The truth is, with the advent of short scar and "mini" lifts, more and more people in their 40's are having these lifts done.

The one thing to mention about a mini lift is, sometimes a mini lift is so mini that it doesn't do anything. Make sure that you will have REAL results, as you are having REAL surgery.

Hope this helps!

Eric Chang, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 10 reviews

Lift the face without a facelift

If you are starting to see jowls appear I would be inclined to recommend a Vampire Facelift® available by a select group of providers including myself to reverse collagen loss and skin laxity coupled with a cheek filler. There is also the simple option of using a thicker filler in the cheeks which will fill out that area thus lifting the jowls up and stretching the skin so it is not so lax. Good luck.

Jennifer Guthrie, MD
West Palm Beach Physician
5.0 out of 5 stars 1 review

Surgery or not!

The truth is that nothing lifts the jowls up like surgery! In these situations I refer to plastics!

But, if surgery is not an option, I use fillers to build up the sides of the cheeks and near the ear area to pull up the weight of the jowls and lift them up. I can also place fillers along the jawline and get the area to look pulled back. It always looks so natural because no one sees those areas as "overdone" as opposed to folds and lips!

I sometimes combine Ulthera to get the extra tightening after.

The combo looks so natural and so great. No surgery. No big recovery. Really gratifying!

Tanya Kormeili, MD
Los Angeles Dermatologist
5.0 out of 5 stars 6 reviews

Treating Jowls with fillers

Thank you for your question. In my opinion, early onset jowls can be treated with fillers injected in front of it between the jowl itself and the chin to camouflage the jowls. Sometimes I add fillers behind the jowl as well in some patients who have tissue loss around the angle of the mandible. In patients who have extensive jowls it is best to undergo facelift/necklift.

I hope this helps. Best wishes. Dr. Salameh (Plastic surgeon - Bowling Green, KY)

Bernard S. Salameh, MD
Bowling Green Physician
5.0 out of 5 stars 19 reviews


Fillers work great for jowling, as does surgery. It just depends if you are ok with a temporary cheaper fix vs a more expensive permanent one.

Kristin J. Tarbet MD, FACS
Bellevue Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

Silhouette Instalift Option

There are several ways to address early jowls. Dermal fillers can help early shadowing along the jawline, however, skin tightening procedures I think are a better options. Although there are thermal techniques with technology such as ultrasound, fractional laser and radio frequency, I have been impressed with Silhouette Thread lift for early aging of the face. This technique works best for the patient between 45-55 who has medium thickness of the skin and early jowls. The technique is performed under local anesthesia and recovery is very quick. The principle is based on absorbable threads with very small cones used to engage the tissue beneath the skin. This technique was approved by the FDA in the spring of 2015 and there are thousands of patients satisfied even if it is touted as a procedure lasting up to two years. Long term follow up has not been done but it is a safe procedure with minimal downtime. The facelift is still a great operation but it is wiser to wait when there is significant jowling to justify the expense and risks.

Robert W. Sheffield, MD
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 29 reviews

Jowls Are Starting to Appear, What Are The Best Options

A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift. During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. 

Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.
The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. But whose skin has elasticity with well defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic may also be a candidate for a Lite Lift™.
If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 110 reviews

Best Options for Early Jowls

The signs of early jowls suggests that there is deflation of the mid face zone with skin starting to sag.  I would suggest treating the proximal deflated areas with a filler like Juvederm initially and subsequently addressing the jowls and jawline.  Hope this information helps.

Praven Chetty, MD
Kelowna Physician
5.0 out of 5 stars 9 reviews

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.