5 Effective Jowl Treatment Options

Written by Elizabeth Geddes-Bruce, MD, Board Certified Dermatologist on September 19, 2018 24 Comments

jowls treatments

Not many areas of the body show a person’s age more than the lower face. Natural aging causes the sleek contours of the chin and jawline to sag from loosening skin around the mouth and cheeks. This excess droopy skin that collects along the lower part of the face (specifically along the jawline and below the cheeks) is commonly referred to as the jowls. Learn more about the causes of jowls in this blog post.

There are several effective treatments to get rid of sagging jowls. People who exhibit early stages of jowl formation can benefit from non-surgical procedures like laser skin tightening or dermal fillers, while others with more severe jowls may require surgical intervention.

jowls example
An example of severe jowls


Dermal fillers can be injected into the soft tissue of the skin to restore lost volume or fill in lines and wrinkles. Fillers can provide dramatic results without the pain and necessary recovery inherent in surgical procedures. To counteract the formation of jowls, fillers can be injected to lift both the cheeks and the skin around the jawline and mouth. One of the best fillers for treating jowls is Sculptra, since it instantly plumps the area where it is injected while simultaneously stimulating new collagen growth to provide a longer-term youthful appearing result. While the results are not permanent, many patients will enjoy a noticeable improvement for 1-2 years or longer.


Thermage is a non-invasive laser tightening treatment with the ability to re-contour the skin. Thermage transfers radiofrequency energy to the deep layers of the skin which firms up existing saggy collagen and elastin fibers while concurrently forcing the production of new collagen. Thermage is a great solution for younger patients who are in the early stages of jowl formation.


Similar to Thermage, Ultherapy is a non-surgical laser-based procedure with the ability to tighten and firm the skin through the stimulation of collagen production. However, Ultherapy uses ultrasound technology to lift and tighten the skin. Many patients receive good clinical results with a single treatment, though some people who have a fair amount of laxity may benefit from more than one treatment. In one study, 70% of Ultherapy patients realized a significant improvement in the neck and jawline that continued to last months after their treatment.

Fraxel (CO2 Laser)

Fraxel Re:Pair is an ablative CO2 laser system that can actually reduce the amount of skin surface through two methods. First, the Fraxel Re:Pair laser ablates targeted tissue (vaporizing tiny columns of the skin). Secondly, the heat transferred during vaporization works to shrink the remaining skin while stimulating new collagen. While more invasive than fillers, Thermage, and Ultherapy, Fraxel Re:Pair and other CO2 systems offer quick and dramatic results as they have the power to reduce the volume of jowl-causing sagging skin within a single treatment.

Neck Lift

Neck lift surgery (platysmaplasty) is the most effective, but also most invasive, treatment for jowls. It may be the only option available to patients with severe jowls or substantial laxity. During a neck lift procedure, 1-inch incisions are made under the chin or behind the ears to the surgically remove excess skin and tighten loose muscles. Compared to other options, neck lifts provide the most dramatic and long-lasting result. However, they are also more expensive and require a longer recovery time.

Elizabeth Geddes-Bruce, MD

Elizabeth Geddes-Bruce, MD is a board certified dermatologist and dermatologic surgeon specializing in the practice of both cosmetic and medical dermatology. Dr. Geddes-Bruce is fellowship-trained in cosmetic dermatology and laser surgery. She served as Chief Resident at one of the nation’s top dermatology programs – The University of Texas at Houston and M.D. Anderson Cancer Center.

24 Responses to “5 Effective Jowl Treatment Options”

  1. Avatar Elizabeth says:

    Hi Dr Geddes-Bruce –

    I am a patient at your office in West Lake and I am interested in creams or treatments to help with the loose skin on my neck. I don’t have double chin but I have loose skin I can actually grab and it stays – it looks like it’s just lost its elasticity! Is there a cream or anything I can do to help? I’m 39 and I’m in good health and my skin is fair – not a lot of sun damage or even wrinkles (though I could benefit from botox like anyone else). My neck is my main concern! Please let me know your advice!

    Thank you!

    • WD Staff WD Staff says:

      Hi Elizabeth,

      Thanks for reading our post and submitting your great question! I’ve spoke with Dr. Geddes-Bruce and she provided me with this response:

      “For skin laxity on the neck we usually recommend a combination of treatments to target different parts of the skin. Start with a cream to be used twice daily called Nectifirm (there is even an advanced version with more peptides – and the peptides are the compounds that trick your skin into thinking it needs to build collagen), then a procedure for deeper skin tightening called Ulthera, as well as a series of 3 laser treatments with the Fraxel laser. And of course, sunscreen! Sunscreen prevents further collagen breakdown from UV rays.”

      I hope that helps! We currently sell Nectifirm on our online store Iderma if you are interested. Here is the product page:

      Thanks again,

      WD Staff

  2. Avatar Neil says:

    Really it would work to lose weight from my chubby cheeks.

    • WD Staff WD Staff says:

      Hi Neil, Thanks for reading our post and submitting your great comment. Depending on the specific characteristics of your cheeks, a better treatment option may be buccal fat removal. You can learn more about that in this blog post:

      The best thing you can do is get an in-person consultation with a skilled plastic surgeon. Through the assessment a skilled surgeon can provide you with the best treatment option for your needs.

      WD Staff

  3. Avatar Nancy says:

    Hello…. I’m a young 71 year old woman with lots of sun damage, especially my jowls. The Jowls are the big issue I would love to correct-without surgery-as quickly as can be done . Please let me know what to do…..thank you so much for this

    • WD Staff WD Staff says:

      Hi Nancy,

      Thanks for reading our post and submitting your great question! The best route for you to take at this point would be to get an in-person consultation with a dermatologist or cosmetic surgeon. They’ll be able to access your specific needs and recommend the best non-surgical treatment options to achieve your desired end results.

      We hope that helps!

      –WD Staff

  4. Avatar Kate says:

    Non-surgical jowl reduction methods are very effective. Methods like dermal fillers, anti-wrinkle injections, radiofrequency treatments, etc.

  5. Avatar Lisa says:

    After having just having 10 nova threads jowls midface can I add s filler to my face, not allot face looks thin, I have always used filler last ten years never used threads before, but the fill for me personally seems to dissipate faster than usual, and it’s more expensive than the threads but it gives me more youthful look. I had an actual midface lift when I was 47, looked great lasted about 14 yrs. The doctor was excellent. Recovery time allot longer than using fillers, why I chose to try them and then th threads. Not overly impressed with the threads just doesn’t give that more youth full look. Will added filler with the threads in place, help, or is that a no no ? Sorry for the long question. Lisa Burfick

    • WD Staff WD Staff says:

      Hi Lisa,

      Thanks for reading our post and submitting your great question! It is possible to add fillers to enhance the results provided by threading. However its impossible to say for sure without assessing you in person. Thus we would recommend you seeing a skilled provider for an assessment. A skilled provider will be able to recommend the best treatment options to achieve your desired results. If you are in the Austin area, please feel free to give us a call for an appointment!

      WD Staff

  6. Avatar Matt says:

    Enjoyed reading this, very good stuff. Thanks!

  7. Avatar Jen says:

    Ran across this site and really wanted some good advice for someone that has never had any facial treatments and would like to know what you consider are the better options for me. I am 51, asian decent with areas of the chin and sides of mouth losing it’s elasticity, making me look older. I’d like some help with tightening this area without anything too aggressive. I’ve seen some bad mishaps with Ultherapy 🙁 I can tell that along with this newly sagging skin under chin, I am also starting to lose fullness around my mouth and sunken under eyes. Please give your adivce on what producres may be of help without surgery. Thanks kindly,
    Jen from California

    • WD Staff WD Staff says:

      Hi Jen,

      Thanks for reading our post and submitting your great comment! Ultherapy is a great treatment, however it should only be done by experienced professionals. I take it some of the mishaps you’ve seen are probably from less experienced providers, so you may not want to rule that out completely without consulting with a skilled provider first.

      Thermage is another great alternative, our patients have been expereincing great results! Fillers may be a good alternative depending on the specific characteristics you’ve mentioned.

      It’s really hard to give you good direction without assessing you in person. So the best advice we can probably give is to find a board certified dermatologist and seek an in-person consultation. Many will offer free consults where they can asses the current characteristics of your skin and guide you through the best treatment options.

      Hope that helps!

      –WD Staff

  8. Avatar Michael says:

    I’ve recently discovered a factor that is contributing to the puffing out or sagging of the skin along my jawline. I would’t have considered them to be Jowls because I am a young looking 45, but in a way I suppose they are. Recently I had an outbreak of ingrown whiskers and was attempting to remove them ate home. Pop the zit, see how close to the skin surface the whisker was sitting then attempt to pluck it out. This was getting frustrating because I was often removing one whisker but then there was another,sometimes another etc. Some of the big fat whiskers are actual multi hair whiskers and seem to always return to the same follicle, which seem to be “problem pores” as the same ones over and over are prone to multi hair whiskers, acne, ingrown whiskers and small lumps that remain even after the surface looks clean. I came to the conclusion that at some point these follicles were damaged and I linked these locations to spots where zits would show up, never fully mature so all squeezing would do is make it swollen and red so most of the time I would leave it and eventually it would satisfactorily go away but never fully so over time these “repeaters” sustain damage causing them to grow the “multies” which are more likely to ingrow and become messy as I found out there is no guarantee to get all the hairs out of a location which makes them more likely to be even uglier the next time. Plus, leading to a great amount of frustration, as I was plucking(digging) away with the tweezers and always chasing the black hair spot until I was walking around with some pretty large embarrassing open wounds on my face. Then things got real. After I finally added a very sharp needle to my arsenal of a couple of different sized tweezers and a small pointy sharp scissors with a tiny upturn in the steel at the end to hook it if I caught it to use some real leverage to pull some of these out because honestly, i am a strong guy with a high pain threshold, some I just could not pull out which really begged the question WTF are these things attached to? Then the answer…one day I’m not sure what I hooked or stabbed with with my needle but it became a high intensity bleeder that contained very large lumps of partially coagulated blood that in the middle was contained a small piece of old whisker that probably had a ratio of 1/100,000 in terms of relative size of hair to blood which I concluded was there to protect me from infection. Well I had to see more. Soon I would catch something so painful to pull out it felt like an incredibly thin, long, and what felt like sharp hair that I could feel sliding out the whole way but could not see on the tweezer. A closer look revealed a microscopically thin hair. Finally, as the digging in multiple locations on my face continued, these problem areas also contained large volumes of very dark red blood that contained many dark, and clear, course whiskers surrounded by a white/clear sheath once again to protect I think but the whole structure was quite degraded. This evening I believe I completed the draining of one especially cranky one which also had a crusty layer underneath the skin and I have gone on to discover that if you look closely enough different areas of the face have different textures of skin, coarseness of hair, ease of extraction, not only amount of pain but feeling or type of pain and commonality of multies which extends to the amount repeaters, or vice versa. Chicken or egg, does the damaged follicle produce the multi or does the multi damage the follicle. I would say the damaged follicle produces the multi and the commonality of all the factors that lead to the nasty never clear up zits/ingrowns/bleeders/crusty layers/ difficult to extract. harshest pain coincidentally run along the jawline area, or the area we see jowls show up as we age. The volume of schmutz that came out of this last one plus a combo below it that i actually cut a straight line along my jawline with my razor sharp jackknife to connect these very painful three follicles where it is next to impossible to extract a fully formed whisker complete with full root structure. Note to anyone who tries this. If there is a crusty layer of what seems to be composed of old schmutz, scab, very small pieces of whisker etc I don’t care how sharp your knife is, dragging that blade through there is not pleasant. Anyway once these areas were drained there is a noticeable difference in that side of my face to the other. It is much thinner and cuts at more of an angle instead of curving out to form the jowl shape. I’m sure I’m not the only man with this but I have not been able to find this online anywhere and you can find some pretty heinous stuff in terms of pulling stuff out of your skin with tweezers. I am feeling it right now and I would volunteer this is a major contributer to the jowls that form on men. Unfortunately this is a long, painful process that requires multiple opening of the same location to fully extract because the mass(which I forgot to mention is the structure holding the impossible whiskers to pluck in place) has a tendency to move out of the direct line of the hole and you need a pretty strong stomach to dig into your face like that to get it. Anyway if this turns into an idea that will help millions of men world wide, give me a shout, we can work together on this.

    Thanks, have a good night!!

    • Avatar Gloria says:

      First of all you need to exfoliate. You have caused a lot of scar tissue by what you have been doing! NO KNIVES PLEASE ! You keep getting the ingrown hairs because you have caused scar tissue to form over the pore opening by picking and breaking the skin. You are also probably not getting the root out and are breaking the hair off below the skin surface. When the hair keeps growing, or a new hair starts to grow, it cannot break through the tough scar tissue, and forms the bump. Lots of times you can see the hair curling under the skin surface. The other crusty, pus…gross stuff in there is a sign of infection. Sea Breeze will take off the old dead skin and acts as an anesthetic as well as a mild exfoliant . I hear that a 2% salicylic acid product is a good exfoliant too. (Google one, but I like Sea Breeze. It seems to dissolve dead skin cells and causes no irritation. Cooling sensation – thus the name.) I get ingrown hairs on my legs from shaving over goose bumps 🙂

      Solution : Before you start picking make sure your face and tools (a fine sewing needle, tweezers) are thoroughly sterilized. Hold a warm wash cloth on the area to soften the skin. This causes the pore to open up – releasing its grip on the root so that it all comes out. Use the fine needle to pierce through the skin/scar tissue. Sometimes you can reach under the hair and coax it out through the tiny hole that you made. (I suggest using a 10x lighted magnifying mirror so you can really see what you are doing!) If its a red pus filled bump – scratch a tiny opening at the tip of the bump and go ahead and give it a little squeeze- and the hair will show itself. Use that alcohol on a cotton ball every chance you get – before during and after doing any of this. Use the warm compress again before you dig at the hair, if you have to, and be careful with those tweezers ! Grab ONLY the hair, it’s easy to grab skin too if you can’t see what you are doing. Relax your face when you pull on the hair VERY SLOWLY – and the whole hair – root and all – will come out. Believe it or not tightening your muscles will make the pore tighten up and the hair will break off – leaving the root, and cycle will continue. Put some neosporin on the spot so it won’t get infected. Keep using the Sea Breeze even after it’s healed up to keep the scar tissue from forming – until the new hair makes its’ way back out of the pore. As for the multiple hairs coming out of one follicle – guys that try to grow a beard would be extremely jealous. That is perfectly normal. Most people have multiple hairs growing out of one follicle – especially on their heads. Unfortunately, I’m not one of them:(
      Side note : keep plucking at one hair enough times and eventually it will die. Might take years though, but my eyebrows are proof, lol 🙂 (I also had a chin whisker that finally gave up , ha ha.) I’ve seen a lot of guys that have your same problem – and it’s all I can do to keep from saying “let me at ’em” ! Good luck, be patient, it will work. Besides – you could really give yourself a serious blood infection (sepsis) by doing it the way you are. NO MORE KNIVES, RAZORS…PLEEZE ! Seriously – I lost my best friend from something very similar to what you are doing. Peace and Love.

  9. Avatar Beverly says:

    Do you believe that facial and neck exercises can improve the muscle and tone, reducing sagging jowls?

  10. WD Staff WD Staff says:

    Hi Beverly,

    Thanks for reading our post and submitting your great question! Facial and neck exercises can provide limited improvements so they do have a place in aging prevention. Specifically they may help stave off sagging thus they are only helpful before the signs of aging become apparent.

    The exercises are ineffective for treating already occurring sagging. Moderate to severe sagging of the jowls will require medical intervention (be it surgical or non-surgical).

    We hope that helps!

    WD Staff

  11. Avatar Stephanie says:

    I have been in before and thinking of doing some other things. I had an Ultherapy treatment about 2 months ago and have noticed no difference at all. My jowls actually appear a tad looser to me. I’d like to do something – but not sure what. I want to target those as well as a bit of laser resurfacing (but something I don’t have to take time off from work to do). I’m a bit skeptical about Ultherapy.

    • WD Staff WD Staff says:

      Hi Stephanie,

      Thanks for reading our post and sharing with our community! Your best bet would be to setup an appointment with a skilled plastic surgeon who also does non-surgical treatments. A plastic surgeon may be the best person to assess your jowls and come up with the best course of action as you may require surgical intervention (which often produces more dramatic results than non-surgical treatments). Unfortunately surgery (and deep resurfacing) will require a long downtime but they may be the best option for achieving your desired result.

      If you are in the Austin area please give us a call to setup an in-office appointment!

      WD Staff

  12. Avatar Mariella says:

    Hi Dr. Geddes,
    I am 65 years old and have very fair skin and having the same problem we all face in the jowl neck are with lose skin. I have been researching not so invasive procedures and I’m a bit scared of surgery. Over the years I’ve had fillers and Dysport injections but my concern is mostly the bottom portion now. Between these, which would be the best alternative: VolumaXC, Sculptra, Instalyft, Revanesse Versa, or Thermage. Also, someone mentioned Kybella but I see downtime is no good.
    Thank you,

    • WD Staff WD Staff says:

      Hi Mariella,

      I forwarded your great question to Dr. Geddes and here is her reply:

      The best thing to do to try and achieve noninvasive skin tightening is to consider a series of Genius radiofrequency microneedling treatments, often in combination with carefully placed filler. The type of filler used is not as important as the experience and skill of the person doing the injecting, so trust your injector when they evaluate your face and decide to you a particular product to meet your needs.

      As always we recommend coming in for an in-person consultation, its the best way to find out which treatment options would be effective for your unique needs.

      We hope that helps!

      WD Staff

  13. Avatar Tracie says:

    Hi, I have very slight beginnings of jowls. The skin is firm but my jawline is softening. I have full cheeks and don’t want to lose them. I bought a Myolift mini and haven’t seen any improvement. Do you think at home microcurrent works for lifting? Is there a better at home modality? What about red light therapy for jowls? Thank you for any advice.

    • WD Staff WD Staff says:

      Hi Tracie,

      Great question! As always, the exact answer would require us to see you for an in person assessment. That being said, we typically do not hear about at-home devices/treatments working for jowls. We do see many people in your same situation, with early jowl development who have tried at-home devices.

      You may want to keep Mylolift a try for a longer period. If you still do not see results we’d recommend you see a dermatologist in your area, there are a lot of non-surgical in-office treatments that will be more effective than anything you can get at-home.

      We hope that helps!

      WD Staff

  14. Avatar Veronica says:

    Hi! Came across your site and found it to be very helpful, thank you! I’lol be turning 49 soon and starting to notice laxity in the lower face area especially the jowls. I notice it more after hard cardio exercise or heavy training. Just wondering if you’d recommend Kybella, Ultherapy and/or fillers to treat this? Thank you in advance.

    • WD Staff WD Staff says:

      Hi Veronica,

      Thanks so much for reading our post and for submitting your great question! As always, we would recommend you seeing a provider for an in-person assessment. It’s really the only way to determine the best treatment option for your specific needs/goals.

      That said, it sounds like the laxity and jowl formation are at their early stages which makes you a great candidate for a non-surgical option. More than likely Ultherapy or Thermage would be a good fit.

      We hope that helps!

      WD Staff

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