We’ve all heard about “jowls,” but what are they really? Here’s Tara’s take on jowls and how she and her team attack them…
What are jowls?
This is the vertical fold that occurs in the skin & soft tissue at the junction between the lower jawline & chin. It can also include the fuller part of the jawline behind that fold that becomes saggy and lax. It sometimes can look like a bulldog.
Why they form
In a word: AGING. But more specifically, it’s multifactorial. First, the loss of collagen & elastin causes skin to sag. Add in loss of boney support to the mandible (the bottom jawbone) in the deterioration of the gonial angle and prejowl sulcus, which causes the superior (upper) & inferior (lower) jowl fat pads to fall forward. Just in the front of these fat pads lies a group of muscles in the face that literally attach to the bones at this exact location. So, as this fat pad falls forward, it creates a fold.
Jowling can also occur with extreme or rapid weight loss, like with GLP-1s (semaglutide/Ozempic/Wegovy, tirzepatide/Mounjaro, Zepbound). The upper face’s fat pads diminish along with the body fat, and coupled with the extreme loss of collagen seen in rapid weight loss, and voila – a jowl.
The effect of jowls
These lower face folds give the appearance of being sad, mad, and/or tired, even if you may not be! They also make you appear older than you may actually be.
How to address jowls
There are a few ways we at Elevated Aesthetics tackle those pesky jowls.
- Surgical: often the best result, but clearly the most invasive & costly. Options can include a facelift and/or buccal fat removal. If you’re at all interested, we can make a referral to plastics surgeons we love.
- Non-surgical (our specialty):
- Replacement of volume loss (gonial angle, jawline/mandible, preauricular space (the area above the gonial angle & in front of the ear), cheeks, possibly temples) with Radiesse (ideal anytime but particularly if you’re on a GLP-1), Sculptra (but not if you’re on a GLP-1, as you likely won’t respond until you’re off of them), or dermal filler
- Disguise the actual fold with filler. This is a phenomenal “one-and-done” treatment, but I don’t recommend to repeat it over and over as it can make this area appear heavy & full over time. Also it’s not treating the root cause: remember, that’s bone loss and volume loss!
- Debulk the fat pad & tighten the skin with Matrix RFM! The only RF Microneedling system that allows the provider (that’s me!) to decidedly target fat pads with true intention is the Matrix platform by Candela. It gives me real-time feedback on whether I’m in a fat pad (which can be a good thing in this jowling situation you’ve found yourself in), and how the tissue is responding to the RF energy. Any other RFMN device is essentially “shooting blind.”
