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Jowls are the sagging skin and fat that hang along the lower face and jawline. They are a natural part of the ageing process, but several factors can cause jowls to develop faster, such as genetics, facial expressions, weight loss, sun exposure, smoking, and the use of computers or phones. The muscles in the face, particularly the jaw muscles, can lose tone over time, contributing to the formation of jowls. Treatments for jowls include facial exercises, injectables, and surgery. Facial exercises can help strengthen the underlying muscles and improve muscle tone, while injectables such as Botox and fillers can be used to relax and weaken the muscles, reducing their downward pull on the lower face. Surgery, such as a neck lift, involves cutting away excess skin and tightening the surrounding muscles.
| Characteristics | Values |
|---|---|
| Definition | Sagging skin around the cheeks and mouth that falls to the area around the chin and jawline |
| Causes | Ageing, genetics, facial expressions, weight loss, sun exposure, smoking, use of computers or phones, damage, poor diet, repetitive facial motions, sudden weight loss |
| Treatments | Facial exercises, dermal fillers, Botox, fat reduction injections, neck lift surgery, creams and lotions high in antioxidants, face yoga, facelifts |
| Muscles Involved | Platysma, DLI, DAO, Mentalis, Masseter |
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What You'll Learn
Facial exercises to reduce jowls
Jowls are caused by sagging skin around the cheeks, jaw, neck, and chin, which can be due to genetics, stress, repetitive facial habits, lifestyle choices, and the natural process of aging. Facial exercises can help reduce the appearance of jowls by strengthening the facial, jaw, and neck muscles, improving their ability to hold their shape and reducing sagging.
Yawning and Opening the Mouth: Start by yawning and opening your mouth as far as possible. Then, close your mouth very slowly without letting your teeth touch. This exercise helps stretch and engage the facial muscles, improving their flexibility and promoting a more defined jawline.
Puckering the Lips: Lie down and pucker your lips outwards. Use your fingers to gently draw the sides of your mouth downward. This exercise targets the muscles around the mouth and cheeks, helping to reduce sagging and improve facial contour.
Blowing the Cheeks: Blow your cheeks up as far as comfortable. This exercise works the buccinator muscles, which are thin muscles in your cheeks that help control facial volume and tightness.
Chewing with Head Tilted: Chew with your head tilted slightly upward. This exercise works the masseter muscles, which run from your cheeks to the sides of your jaw and help with jaw movement and chewing.
Grinning and Head Tilt: Grin as widely as comfortable, then slowly tilt your head up and down. This exercise targets the levator anguli oris and levator labii superioris muscles, which are involved in smiling and facial expressions.
Lip Placement and Head Tilt: Place your lower lip on your top lip and tilt your head upward. This exercise works the depressor labii inferioris muscle in your chin, helping to control the movement of your lower lip and reducing sagging.
It is recommended to hold each exercise for 5 to 20 seconds and repeat 8 to 12 times, several times daily. Additionally, it is important to perform the exercises one after another to ensure the facial muscles are worked evenly.
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Invasive treatments for jowls
Several cosmetic procedures can address jowls, which are a common concern for many men and women, and can make individuals look older. Jowls are caused by sagging facial muscles and a loss of collagen and elastin in the skin. While some non-invasive treatments are available, more severe jowls may require surgical intervention.
Surgical treatments
For those with more pronounced jowls, surgery may be the best option. A full facelift requires incisions around the ears and into the hairline, while a mini facelift uses shorter incisions and less extensive dissection under the skin. Liposuction and neck lifts are also surgical options that can address jowls. These procedures typically require anaesthesia and have lengthy recovery periods.
Invasive treatments
Several invasive treatments can address jowls without surgery. These include:
- Dermal fillers, such as Sculptra, can be injected to lift the cheeks and the skin around the jawline and mouth.
- Botox injections can be used to reduce the appearance of bands across the neck and lift wrinkles, giving the neck a more youthful appearance.
- Kybella is an injectable treatment that melts away fat cells in the chin and jawline, resulting in a more defined jawline.
- CoolSculpting Elite is a safe and effective way to reduce fat and improve the definition of the jowls, chin, and jawline.
- Thread lifts are a minimally invasive procedure in which dissolvable threads are inserted to lift and support sagging skin.
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The role of genetics in jowl formation
The development of jowls is influenced by various factors, including genetics, age, weight changes, and lifestyle choices. While jowl formation is inevitable and a natural part of ageing, genetics play a significant role in determining its onset and severity.
Genetics is a crucial factor in the formation of jowls, and it can run in families. If one or both of your parents have prominent jowls, you are more likely to develop them as well. Additionally, certain genetic traits, such as naturally thin skin or lower levels of collagen and elastin in the skin, can make individuals more susceptible to developing jowls at an earlier age.
Collagen and elastin are essential proteins that provide structure and elasticity to the skin. Over time, the skin loses these proteins, particularly in the areas around the cheeks and jawline, resulting in sagging and the formation of jowls. Genetics influence the levels of collagen and elastin in the skin, and individuals with lower levels may experience premature ageing and the early development of jowls.
While genetics play a significant role, other factors also contribute to jowl formation. Ageing is a natural process that leads to a loss of elasticity in the skin, making it less resilient and more prone to sagging. This loss of elasticity can begin as early as the late 20s, according to plastic surgeon David Shafer, MD, but typically becomes more noticeable in the 50s to 60s.
In addition to genetics and ageing, extreme weight fluctuations can also contribute to jowl development. Dermatologist Doris Day, MD, explains that jowls can result from the shrinking of the jawbone, recession of the chin, loss of fat and collagen, and the shifting of fat pads. Lifestyle choices, such as smoking, excessive sun exposure, and prolonged use of computers or phones, can also accelerate the formation of jowls and worsen their appearance.
While genetics play a significant role in jowl formation, a combination of factors usually influences their development. By understanding the interplay between genetics and these other factors, individuals can take preventative measures and explore treatment options to minimise the appearance of jowls.
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Jowls and loss of collagen and elastin
The term "jowls" refers to sagging skin below the jawline. Jowls are caused by the thinning of the skin and a loss of elasticity, which is a natural result of the ageing process. As the skin ages, it loses fat and connective tissue proteins, including collagen and elastin. Collagen is a protein that makes up the connective tissue in the body, while elastin is another connective tissue protein that allows the skin to return to its normal shape after being stretched. As these vital proteins are lost, the skin around the cheeks and mouth loses its firmness and tightness, causing it to sag under the jawline.
Certain lifestyle factors can contribute to the development of jowls and the loss of collagen and elastin. Smoking, for example, can damage collagen and elastin fibres, and the chemicals in cigarettes can narrow blood vessels, limiting blood circulation and preventing the skin from getting the nutrients it needs to stay healthy. Excessive use of computers or smartphones can also cause the skin around the neck to lose its elasticity over time, leading to the formation of jowls. This phenomenon has been dubbed "tech neck".
To prevent and treat jowls, it is important to focus on restoring collagen and elastin levels in the skin. This can be achieved through various procedures and skincare regimens. For instance, treatments like Sculptra injections, Broadband light therapies, and SkinPen's collagen induction therapy aim to stimulate collagen production in the skin. On the other hand, non-invasive alternatives, such as specific skincare products, facial massages, and facial yoga, can also help restore collagen and elastin levels over time.
Additionally, certain facial exercises can be performed to reduce the appearance of jowls. These exercises target the facial muscles, helping to improve their shape and ability to hold the skin in place. Some recommended exercises include yawning and opening the mouth as wide as possible, then closing it slowly without letting the teeth touch, puckering the lips outwards, and blowing the cheeks up. These exercises should be performed one after another, holding each for 5 to 20 seconds, and can be repeated several times a day.
In more severe cases, surgical procedures such as neck lifts and dermal fillers may be considered. Neck lifts involve tightening the skin and sculpting the fat and tissues in the jaw and cheek areas. Dermal fillers, on the other hand, are injected into the cheeks to fill in areas where fat has been lost, thereby lifting the skin around the jawline and reducing the appearance of jowls.
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The mandibular ligament and jowls
The jowl is a feature of an ageing human face, characterised by sagging skin around the cheeks and mouth, which falls towards the chin and jawline. Jowls are considered a stigmatising feature, and their formation is a reason why people consider lower facial rejuvenation surgery. The anatomical changes that lead to the formation of jowls are not yet fully understood.
The jowl is situated in the supra-platysmal plane, as redundant subcutaneous tissue with overlying skin. The area of maximal jowl fullness corresponds with the area over the posterior end of the mandibular ligament. The mandibular ligament does not have a definitive subcutaneous component. Instead, it is formed by the combined muscular attachment to the mandible of the specific lower lip depressor muscles and the platysma. The platysma is firmly attached to the outer margin of the mandible, and the mandibular ligament is included within the posterior end of this attachment.
The mandibular ligament is central to the development of jowls with ageing. The ligament itself has been reported with considerable variation regarding its position and extent. Recent studies have described the mandibular ligament to extend up to 65 mm from the midline and 45 mm from the gonial angle, which is much more posterior than the anterior border of the jowl. The jowl forms in the subcutaneous layer, where it overlies the posterior part of the mandibular ligament.
The subcutaneous retinacula cutis fibres attaching the skin to the platysma are longer in the area of the jowl than in other areas. This allows significant mobility of the skin over the fixed platysma and the underlying mandibular ligament when opening the mouth. The length of these fibres means that they cannot be perceived when dissecting in the deep subcutaneous plane, as they are cut at their base.
The labiomandibular crease marks the posterior extent of the fixed dermal attachment of the depressor anguli oris muscle. Jowls develop as a consequence of ageing changes to the functional adaptions of the mouth. To accommodate a wide jaw opening, the tissues overlying the mandible must be hypermobile. This hypermobility over the mandibular attachment of the lower lip depressor muscles occurs entirely in the subcutaneous layer, allowing the mandible to move independently from the skin. The short, elastic subcutaneous connective tissue lengthens with age, resulting in laxity. The development of subcutaneous and dermal redundancy constitutes the jowl.
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Frequently asked questions
Jowls are sagging skin/fat that hangs along the lower face and jawline.
Age is the primary cause of jowls, but several factors can cause them to develop faster, including genetics, facial expressions, weight loss, sun exposure, smoking, and computer or phone use.
While almost everyone eventually gets jowls, some lifestyle choices can help reduce the risk of early development. This includes using creams and lotions high in antioxidants that promote the production of collagen, such as retinol, vitamin C, and vitamin E, as well as avoiding habits that cause the jaw and cheek muscles to face downward, such as chewing gum, frowning, and using a computer for long periods.
There are various treatments available to minimise the appearance of jowls, ranging from free and easy facial exercises to expensive, invasive face lifts and neck lifts. Injectable solutions such as wrinkle relaxing injections, fillers, and fat reduction injections can also be used to improve the appearance of jowls.
