Jowls worse after jawline fillers three years ago. Will dissolving old filler fix jowls? (Photo)

Question

I’m in my 50s. 3 years ago I got jawline fillers (Voluma XC). My jowls are worse, could dissolving help my face go back to its old shape?

Waylon Zeng, MD · Answer

Hi there thank you for your question and sharing your photos. You are concerned about the jowls developing on your jawline. While it's not clear how the fillers were injected and in what location, it's also possible that the jowls may have also become more prominent over the last few years. Patients in their 50s will often times suddenly realize a big change in their face one morning (even though it's actually a bit more gradual in reality). Filler migration is definitely a possibility, but I think normal aging may also be a large contributing factor. Hope that helps!

Behnoush Zarrini, MD · Answer

Hello and thank you for sharing your photo and your concerns. As a practitioner at Beverly Wilshire Aesthetics, I completely understand your frustration regarding your jawline changes. While Juvederm Voluma XC is typically marketed to last up to two years, modern imaging shows us that hyaluronic acid fillers can persist in the facial tissues for much longer. Over a period of three years, it is entirely possible that the filler has migrated downward or is retaining excess water. This retained product can add physical weight to your lower face, which pulls down on the tissue and makes jowls appear heavier than they otherwise would. If this is the case, dissolving the remaining filler with a hyaluronidase enzyme could effectively reduce that specific heaviness and improve your contour.
However, it is crucial to understand the realities of natural aging before proceeding with treatment. Over the past three years, your skin has naturally lost collagen and elastin, and dissolving the filler will not return your face entirely to the shape you remember. In fact, if the filler is currently providing some underlying structural support, removing it might actually make the skin laxity more apparent. I highly recommend visiting an expert injector for an in person consultation so they can feel the tissue and determine how much product remains. They can guide you on whether dissolving the old filler or exploring skin tightening treatments will be the most effective path forward for your specific anatomy.

Carl Truesdale, MD · Answer

This is a common scenario and frustrating because the well-intentioned treatment made things worse. Here's what likely happened and the path forward.
What probably happened: jawline filler placed three years ago has either migrated downward into the jowl pocket, integrated into surrounding tissue creating a heavier appearance, or accumulated with subsequent treatments. The added weight of the filler can pull the jowl down further over time, especially if there was already early tissue laxity.
Step one: imaging and dissolving. Get an ultrasound to map remaining filler if possible. Then dissolve the existing product with hyaluronidase. This usually takes 2 to 3 sessions over several weeks because old filler can be resistant. Wait 6 to 8 weeks after dissolving to reassess.
Step two: re-evaluate your underlying anatomy. Once the filler is gone you can see what you actually have. Sometimes the jowl is fine after dissolving. Other times the descent and laxity are real and need addressing.
Step three: depending on what's underneath, choose between:
Surgical lifting (lower facelift or deep plane facelift) if jowls and skin laxity are significant. This is the definitive answer for jowl correction.
Selective re-injection in a more conservative pattern (less volume, different placement) if you want to maintain the contour without surgery.
Energy-based treatments (Ultherapy, RF microneedling) for mild laxity and to delay surgical needs.
What I'd avoid: adding more filler to mask the problem. This is the most common mistake and makes the long-term picture worse.
Bottom line: dissolve first, evaluate clean anatomy, then decide. Find a surgeon who is honest about whether filler or surgery is the right move. If yours always pushes more filler, get a second opinion.

Frank Agullo, MD · Answer

Dissolving old jawline filler is usually the first move, not the last. Filler placed three years ago is rarely gone. Hyaluronic acid sticks around far longer than the marketing claims, and on the jawline it migrates downward over time, settling into the prejowl sulcus and amplifying the shadow you read as jowls.

Hyaluronidase (Hylenex or Vitrase) in the office can dissolve a meaningful amount in two visits, two weeks apart. Many patients are surprised at how different the jawline looks at week four, often softer and tighter rather than emptier.

After the slate is clean, the real question is whether your jowls are mostly a soft tissue laxity story (treat with RF tightening, deep plane facelift, or FaceTite) or a fat redistribution story (re inject conservatively along the jaw with structural product). Most patients are a mix.

#StayBeautiful,

@RealDrWorldWide

Nelson Lee Novick, MD · Answer

Yes, that's right. You might actually need a robust HA filler cheek augmentation and/or posterior jawline HA filler contouring to address the current problem. 
A full face front face photo and a full profile profile would be extremely helpful to determining how best to address the jawline jowls.
Since the cheeks provide lift to the lower face, it there is volume deficit in the cheeks, then addressing this issue with the use of a robust HA lifting filler would by itself help the lower face and straighten the jawline. Volume loss in the posterior region of the face, near the ears, may also do so, And, the use of a robust HA contouring filler in that region can also help to straighten a saggy jawline. 
Frankly, it is quite possible that these may have all that was needed in the first place, without the need for an anterior jawline volumizing filler. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injector expert. Hope this helps and best of luck.

Skin Social · Answer

It’s possible that residual filler could be contributing to heaviness or increase the appearance of the jowls, especially with a firmer HA filler like Voluma. Over time, filler can shift, retain water, or simply become less supportive.
Strategically dissolving part of the filler can improve contour. However, it’s important to remember that some of what you’re seeing may also be related to the natural progression of skin laxity and tissue descent that continued naturally over those 3 years.
The key is determining whether the issue is residual filler creating bulk/heaviness, true jowl formation from laxity, or a combination of both.
An experienced injector can often assess this by palpating the area and sometimes using ultrasound to evaluate how much filler is still present. If significant filler remains, gradual dissolving may help restore a softer, more balanced contour. 
Depending on the degree of laxity, additional options after potential dissolving may include biostimulatory treatments (such as Sculptra or hyperdilute Radiesse), RF microneedling/skin tightening, PDO threads, or surgical lifting procedures. I hope this provides you some clarification!

Camille Cash, MD · Answer

The jowls are a result of skin laxity.  To correct them you want to address this through skin tightening.  This can be done through surgical options like a facelift or you can consider less aggressive options.  The correct procedure will depend on your goals for treatment.  Non surgical treatments to consider include FaceTite and Morpheus8.  These treatments are great for those who are not yet ready for a surgical facelift but would like some improvement to skin laxity.  See a board certified plastic surgeon near you to learn more.

Darryl J. Blinski, MD · Answer

Photo shows jowls agreeing that need laser Junera treatment to tighten 
Fee $10,000. Best to virtual consult with.

Jowls worse after jawline fillers three years ago. Will dissolving old filler fix jowls? (Photo)

Answers (8)

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