23 Dec 2025
Facial aging is individual. While collagen and elastin levels decline for everyone starting around age 25, the rate at which your skin and tissues exhibit this loss is going to depend, in large part, on your genetics and lifestyle choices. If you spent a lot of time outdoors in the sun without sunscreen, it is going to show up on your face as not just sun spots, but also loose, sagging skin. The other thing about facial aging is that what bothers one person may not bother another. For example, you may embrace your crow’s feet while your best friend treats them regularly with Botox®. Again, it’s personal. But there is one thing that is fairly universally disliked and that is “jowling”. Affecting both men and women, this is a term to describe the heaviness that develops in the lower face, resulting in deep folds around the mouth and a loss of definition at the chin/neck juncture. Many patients want to know: “Is a facelift the only option to improve jowling?”. No, but it’s often the best option. Here are some things to consider when it comes to rejuvenating your lower face.
What is Causing Your Jowling?
Before deciding on a course of treatment, the first thing to determine is the underlying causes of your jowling. Since aging is multifactorial, there is typically more than one issue at play. These may include:
- Loss of collagen
- Decline in elastin
- Fat loss in mid-face/cheeks
- Weight gain/loss
- Menopause
The end result is sagging tissue that creates folds in the lower face and possibly a loss of definition at your chin/neck juncture. At Boston Center for Plastic Surgery (BCPS), we are all big advocates for scheduling an in-person consultation. While the internet can be a great resource for self education, it did not go to medical school. As a double Board-Certified Facial Plastic Surgeon, I have a deep understanding of the various procedures for rejuvenating the lower face as well as the pros and cons of each. During our consultation, I will listen closely to what bothers you about your face and ask in-depth questions about your lifestyle, medical history, family history and any prior procedures you may have had. I will also perform a thorough physical exam.
Non-Surgical Procedures for Mild to Moderate Jowling
While the in-person consultation serves a number of important functions, including the opportunity for the two of us to get to know each other, the physical exam is critical. It allows me to assess your:
- Skin tone & texture
- Areas of volume loss
- Muscle laxity, if any
Once I’m armed with this data, I will be able to give you an honest assessment of the severity of your jowls. For those with only a mild to moderate amount of loose skin in the lower face, there are some effective non-surgical options such as:
- Dermal fillers
- Skin tightening devices like Profound®
- Energy based treatments such as CO2 Laser Skin Resurfacing
The main benefit of any non-surgical procedure is minimal downtime for recovery. However, it will take multiple treatments to achieve your results. And those results are never going to be as dramatic as a surgical result. But non-surgical facial rejuvenation can be a great in-between step for younger patients and for those who either can’t have surgery due to a medical condition or simply do not want it.
Deep Plane Facelift is the Gold Standard for Jowling in Boston
For significant jowling, a deep plane facelift or lower facelift remains the most reliable and long-lasting solution. With this cutting-edge technique, I am able to work in the underlying structures of your face, repositioning the muscles and tissues that lay beneath your skin. This delivers an elegant, natural looking and long-lasting result because there is no weird pulling on the surface of the skin. And the rejuvenating effect is the gold standard as I am literally lifting your lower face back into a more youthful position. This eliminates the jowls and restores a crisp look to the jawline. So, while a facelift isn’t the only option for jowling, it is the most powerful one, especially when laxity is more advanced.
To find out more about a deep plane facelift, or any other surgical or non-surgical procedure with Dr. Akshay Sanan at the Boston Center for Plastic Surgery, contact us today or call (617) 402-2768 to schedule a consultation.
