Jowls: Why It Happens and What You Can Do

Medically reviewed by Catherine Hannan, MD on July 14, 2017Written by Tim Jewell

What are jowls?

The term “jowls” is often used to describe sagging skin below your chin or jawline. Almost everyone develops jowls as they age. It happens because your skin becomes thinner and less elastic over time.

Jowls may be less pronounced in people who have thicker skin, more fat, or more collagen in the area below the cheeks and chin. Some people may never develop jowls because of their genes, environmental factors, and lifestyle choices.

Keep reading to learn more about why jowls develop, how you can reduce your chances of developing them, and what you can do to minimize their appearance.

What causes jowls?

Loss of elastin and collagen

Over time, the skin in your cheeks and below your jawline loses much of its collagen and elastin. Collagen is a protein that makes up the connective tissue in your body. Elastin is another connective tissue protein that lets your skin return to its normal shape even after being stretched.

As these proteins are lost, the cheek skin surrounding your mouth loses its firmness and tightness. Once this happens, gravity causes it to sag and descend to the area on either side of your mouth and chin.

Genetics

Your genetics can also determine whether or not you develop jowls and how noticeable they become over time. If either of your parents have jowls, you’re more likely to develop them. If you naturally have thin skin or limited amounts of collagen and elastin in your skin, you may start to notice jowls early in life. It’s possible to develop jowls as early as your teens or twenties.

Environmental and lifestyle factors

Other causes of jowls either come from your environment or result from your lifestyle choices. These include:

Facial expressions: Frequently making certain facial expressions can stretch out your face or neck skin.

Weight loss: When you gain weight, your skin stretches to cover increased body mass. If you lose the weight, the stretched skin may sag.

Sun exposure: Overexposure to ultraviolet (UV) rays in sunlight can damage the collagen in your skin. This can cause your skin to sag earlier.

Smoking: Nicotine and other chemicals in cigarettes can damage collagen and elastin. Smoking can also cause your blood vessels to become narrow. This limits your blood’s circulation and prevents your skin from getting enough nutrients like vitamin A to keep it healthy.

Using computers or phones: Using a computer or looking down at a smartphone for long periods of time can make the skin around your neck lose its elasticity over time. These jowls have been called “tech neck.”

What can I do to reduce my risk?

You may develop jowls because of factors out of your control. But there’s plenty you can do to help prevent jowls from developing or from sagging prematurely.

To prevent jowls

  • Avoid smoking. The chemicals in cigarettes and other forms of tobacco can damage your skin.
  • Limit your exposure to the sun. You should always apply sunscreen to your face and neck before heading out for the day. Make it a part of your morning routine to minimize damage from UV rays.
  • Limit your screen time. Try to keep your head at a natural, comfortable angle when using a computer or phone to keep your neck skin from getting bunched up or stretched out. You can also protect your muscles by taking a 10-minute break for every hour of computer work that you do.

What if I already have jowls?

There are several options for treating sagging jowls or reducing how saggy or droopy they appear. Surgical procedures, such as neck lifts, can tighten your skin and make it look less saggy. Nonsurgical procedures, such as thermage, lasers, and peels, can change the composition of the collagen in your skin. Fillers can be used to camouflage hollow areas around the jowls.

You can also use clothing and makeup to conceal your jowls when you go out. If you’re more interested in home solutions, check out these exercises for a defined jawline.

Surgical options

Surgical procedures to reduce the appearance of jowls are usually done in a hospital or the office of a cosmetic surgery specialist. Make sure to consult with the surgeon before scheduling your appointment so that you can get to know them and be confident that they’re qualified to do the procedure.

Neck lift or face lift

This surgery involves general anesthesia. Recovery takes a few days to a couple of weeks.

A neck lift, also called a lower rhytidectomy, is done by removing fat, tightening muscles, and rearranging the skin around your neck to shape your jawline. The incision is usually placed in front of and behind the ear, extending into your hairline.

In some cases, you may want to do a full facelift. This procedure removes fat, tightens muscle, and rearranges skin also on the lower part of your face so that your neck and face appear the same.

A neck lift typically costs around $4,528 depending on your insurance provider. As with any surgical procedure, risks can include:

  • bruises
  • damage to nerves or muscles
  • internal bleeding
  • complications from anesthesia
  • swelling or improper healing
  • sepsis

Liposuction

With liposuction, your surgeon uses a microcannula to remove fat from your chin area. They also reshape the skin and jawline to prevent future sagging.

You’re placed under general anesthesia for this surgery and will likely spend a few days to a couple of weeks recovering from the procedure. Liposuction typically costs around $3,200.

Risks can include:

  • bruises
  • damage to nerves or muscles
  • internal bleeding
  • complications from anesthesia
  • swelling or improper healing
  • sepsis

Nonsurgical options

Some treatments don’t require any surgical procedures and can be done in an outpatient facility. These procedures don't require general anesthesia, so they typically have fewer risks. However, the results may not be as drastic.

Thermage jawline tightening

This procedure uses heat and radio frequency energy from a tool called the Thermatip to tighten the skin around your neck and chin. It can be done multiple times to ensure that the collagen in your skin stays tight. Recovery time is minimal and the procedure can be done in a single day.

This procedure can cost between $2,000 and $3,000 depending on your insurance provider. Risks of complications associated with this procedure, including infections, are low, but they may increase as you get older.

Dermal fillers

Dermal fillers are made of a material called hyaluronic acid. This material can be injected into your neck and chin to fill in jowls and make them look less saggy. Some fillers can help your body produce more collagen to keep your skin tight.

The cost of dermal fillers depends on your insurance provider and the amount of fillers you need. There are few risks associated with fillers besides infection.

Other ways to reduce their appearance

If you’re not interested in surgical or nonsurgical procedures but still want to reduce the appearance of your jowls, you may consider changing your personal style to help conceal them. Makeup and clothing may help.

Makeup

Using different styles of contouring along your chin and neck can help make your jowl lines less noticeable. You can watch tutorials online or visit the makeup counter at Macy’s or Sephora to get a demonstration in person. The store’s beauty reps can also help you determine which shades are right for your skin tone.

Turtlenecks and scarves

Scarves and turtlenecks aren’t just for staying warm — they also provide coverage. Although turtleneck shirts or sweaters can hide your jowls completely, scarves can be tricky. Avoid sheer fabrics and opt for something more structured to provide reliable coverage.

The bottom line

You have many options for preventing, treating, and concealing jowls if you’re unhappy with them. Be sure to talk to your doctor about the best option for you, especially if you’re older than 60 or have any conditions that could increase your risk of complications after a surgical procedure.

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