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Jowls Treatment in Campbell

Also known as: Jawline Sagging, Lower Face Sagging, Jawline Laxity, Facial Jowling, Sagging Jawline, Mandibular Sagging, Lower Face Laxity

4 min readLast updated: 2026-04-07Reviewed by Dr. Kamakshi R. Zeidler, MD, FACS

Jowls are areas of sagging skin and soft tissue that develop along the lower jawline as part of the natural aging process. They form when the skin, fat compartments, and supporting structures of the lower face lose volume and elasticity, causing tissue to descend below the mandibular border. The result is a loss of jawline definition that can make the face appear heavier or older. Contributing factors include collagen and elastin decline, weakening of facial ligaments, fat redistribution, and resorption of the underlying jawbone.

At a Glance

  • Jowl formation involves deflation of the jowl fat compartments and weakening of the mandibular septum, allowing fat to sag below the jawline[1]
  • Mandibular bone resorption in the prejowl region reduces skeletal support, and jowls may appear at a younger age in individuals with a naturally smaller chin[2]
  • Approximately 78,000 facelift procedures were performed in the United States in 2023, with volume growing 8% year over year[4]
  • Non-surgical skin tightening procedures cannot achieve the same degree of improvement as surgical options like facelift or neck lift[3]
  • Collagen breakdown rate increases while collagen synthesis decreases with age, and elastin production declines steeply after age 40 to 50[1]

Affected Anatomy

  • Mandible (jawbone)
  • Masseteric cutaneous ligament
  • Mandibular retaining ligament
  • Superficial musculoaponeurotic system (SMAS)
  • Jowl fat compartments (superior and inferior)
  • Dermis and subcutaneous tissue of the lower face
  • Platysma muscle

What are the symptoms of Jowls?

  • Sagging or drooping skin along the lower jawline
  • Loss of definition between the jaw and neck
  • Visible fullness or pouching below the mandibular border
  • Deepening of marionette lines extending from the mouth corners
  • Uneven or asymmetric jawline contour
  • Skin laxity and reduced firmness in the lower face
  • Blunting of the cervicomental angle (jaw-to-neck transition)
  • Appearance of a "double chin" in some individuals

When should you seek care for Jowls?

  • Desire for professional evaluation of cosmetic treatment options
  • Concern about rapid or asymmetric changes in facial contour
  • Interest in non-surgical skin tightening procedures
  • Consideration of surgical options such as facelift or neck lift
  • Facial changes occurring alongside significant weight loss

If any of these apply to you, don't hesitate to reach out for help.

What causes Jowls?

Causes

  • Decreased collagen and elastin production with age
  • Weakening and stretching of the masseteric cutaneous ligament
  • Weakening of the mandibular retaining ligament
  • Deflation of the superior and inferior jowl fat compartments
  • Resorption of mandibular bone in the prejowl region
  • Loss of dermal thickness and skin resilience
  • Gravitational effects on aging facial tissues
  • Repetitive facial movements contributing to soft tissue laxity

Risk Factors

  • Age (changes typically become noticeable in the 40s and 50s)
  • Cumulative sun exposure and UV-related photoaging
  • Smoking and tobacco use
  • Genetic predisposition to facial aging patterns
  • Significant weight fluctuations or rapid weight loss
  • Naturally thin facial bone structure (microgenia)
  • Hormonal changes, particularly those associated with menopause
  • Poor nutrition and chronic dehydration

How It's Diagnosed

  • 1Visual assessment by a dermatologist or plastic surgeon
  • 2Evaluation of skin elasticity and tissue laxity
  • 3Assessment of facial bone structure and volume loss
  • 4Review of patient goals and cosmetic concerns
  • 5Photographic documentation for treatment planning
  • 6Assessment of overall facial aging pattern

How is Jowls treated?

At Aesthetx, we offer several approaches for jowls:

Injectable Dermal Fillers

Injectable dermal fillers are FDA-approved medical devices used to restore facial volume, smooth wrinkles, and enhance facial contours. Board-certifie...

Learn more →

Laser Treatment

Laser treatment uses focused light energy to address a variety of skin concerns including scars, acne, acne scarring, hyperpigmentation, melasma, red ...

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Prognosis and Recovery

  • Jowls are a natural part of facial aging and tend to progress over time without intervention
  • Surgical approaches such as facelift can produce significant and long-lasting improvement
  • Non-surgical treatments may slow progression or provide modest tightening
  • Results from minimally invasive procedures are typically more subtle than surgical options
  • Combination approaches addressing multiple layers of facial aging often yield the best outcomes

Frequently Asked Questions

Jowls are areas of sagging skin and tissue that develop along the lower jawline as part of natural aging. They form when supporting structures including facial ligaments, fat compartments, and collagen weaken over time, causing tissue to descend below the jaw. Sun exposure, genetics, and lifestyle factors can accelerate this process.
Common signs include sagging or pouching skin along the lower jawline, loss of definition between the jaw and neck, deepening marionette lines from the corners of the mouth, and a less defined cervicomental angle. These changes typically become more noticeable in the 40s and 50s.
Jowls develop from multiple factors acting together. Collagen and elastin decline reduces skin firmness, facial ligaments weaken, fat compartments deflate, and the jawbone itself can lose volume in the prejowl area. Sun exposure, smoking, genetics, and significant weight fluctuations can accelerate these changes.
Consider consulting a board-certified dermatologist or plastic surgeon if jowls affect your confidence, you want to explore treatment options, or you notice rapid or asymmetric changes in facial contour. A specialist can evaluate your anatomy and recommend appropriate surgical or non-surgical approaches.
Treatment options range from non-invasive to surgical. Non-surgical approaches include radiofrequency and ultrasound skin tightening, dermal fillers, and thread lifts. For moderate to severe jowling, surgical options such as facelift or neck lift can produce more significant and longer-lasting results. A specialist can recommend the best approach based on the degree of laxity.
While jowls cannot be entirely prevented because they result from natural aging processes, their progression can be slowed. Consistent sun protection, avoiding smoking, maintaining a stable weight, eating a balanced diet, and using topical retinoids may help preserve skin firmness and delay the onset of visible jowling.
Recovery varies by treatment type. Non-invasive procedures like radiofrequency or ultrasound tightening typically require no downtime. Thread lifts may involve a few days of mild swelling. Surgical facelift or neck lift generally requires two to four weeks of recovery before returning to normal activities, with full results visible over several months.

Your Physicians

Dr. Kamakshi R. Zeidler

Dr. K. Zeidler

MD, FACS

Dr. Dino Elyassnia

Dr. D. Elyassnia

MD, FACS

Dr. Jane Weston

Dr. J. Weston

MD, FACS

Dr. Bao Tran

Dr. B. Tran

MD

Dr. Shirley Liu

Dr. S. Liu

MD, MHS

Dr. Michele Koo

Dr. M. Koo

MD, FACS

Dr. Rick Lehman

Dr. R. Lehman

MD, FACS

Dr. Jean Gillon

Dr. J. Gillon

MD, FACS

Dr. Amelia K. Hausauer

Dr. A. Hausauer

MD, FAAD

9 board-certified physicians across 4 locations

Sources & References

This article draws from 6 sources, including NIH, peer-reviewed research, leading medical institutions.

Government & Research

Medical Institutions

Educational & General

Medically reviewed by Dr. Kamakshi R. Zeidler, MD, FACS · Last reviewed: 2026-04-10