Surgery the Only Option for Sagging Jowls?

I'm a 41-year-old woman with fairly good skin, but I have slightly sagging jowls. Is surgery the only skin tightening option for this?

Doctor Answers 2

Non Surgical Options For Sagging Jowls

Thank you for your question. For patients in their 40"s with minimal sagging of the jowls the non surgical options include:

  1. Botox or Dysport to Treat the DAO Muscle-this muscle pulls the corners of the mouth down and creates the crease in front of the jowl-relaxing the muscle can lessen this fold
  2. Filler injection into the fold (Marionette Line) in front of the Jowl-There are many fillers, I use Perlane but Sculptra, Juvederm, Restylane and others may be used. This technique plumps the depression in front of the jowl and camouflages the jowl
  3. Non surgical skin tightening-There are many techniques available including Thermage, LuxIR Deep, Titan, Ulthera and others.
  4. Laser Resurfacing-Combined Laser Skin Resurfacing using 1540 non ablative and 2940 ablative fractional Erbium Lasers can tighten facial skin and improve minimal jowling

See a board certified Plastic Surgeon who is experienced at these techniques. Some call them the "Liquid Facelift."

Skin tightening procedures


This is an excellent question that, as a facial plastic surgery specialist, I get asked on a daily basis. There are several options for sagging jowls in someone in their early 40's. The most conservative treatment is to mask the appearance of the jowl by filling the creases around the mouth. Usually using a hylauronic acid filler such as Restylane will serve this purpose well. These fillers usually last about one year.

Second, if the skin is not sun damaged and still retains its elasticity, then liposuction may be an option. This usually is a good treatment for someone who is young and has elastic skin. Most people however, do not fit into this category because the appearance of the jowl itself is a sign of the skin losing elasticity.

The best and most long lasting treatment is a lower face lift. This simple procedure will combine liposuction with a lower face structural lift to "put the jowl back into its proper position." This lift is long lasting and gives fantastic results.

Finally, many patients also ask me about laser skin tightening. I usually tell patients that lasers are unable to "lift" the skin. They can provide some skin firmness, but will not lift the jowl to any degree. Although you may see many companies claiming that their laser can perform this task, I am hesitant to believe it. I have seen too many unhappy patients who have had many many laser treatments with little to no noticable result.

Thanks for your question.

Henry Daniel Sandel IV, MD
Annapolis Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

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