Jowls are the loose skin and soft tissue that settle below the jawline as the face ages. They form when skin loses elasticity, facial fat thins and shifts, and the jawbone itself changes shape. Non-surgical treatments can firm mild to moderate jowls, but the American Academy of Dermatology (AAD) is clear that they cannot match the results of a facelift.
This guide explains what causes jowls, which non-surgical options have evidence behind them, what each can realistically do, and when surgery is the more honest answer.
What are jowls?
The jawline of a younger face usually runs in a fairly straight line from chin to ear. Jowls interrupt that line. They show as a fold or fullness on either side of the chin, often with a small hollow in front of it.
The American Society of Plastic Surgeons (ASPS) lists “jowls developing in the cheeks and jaw” among the visible signs of ageing in the face, alongside sagging skin and deeper folds between the nose and mouth.
What causes jowls?
Several changes happen together. A 2023 review of lower-face treatment in the World Journal of Otorhinolaryngology – Head and Neck Surgery describes them this way:
- Thinner, less elastic skin. The skin produces less collagen and other supporting proteins with age.
- Changes in facial fat. Fat along the jaw thins, and the tissue that holds it in place weakens.
- Bone loss. The jawbone recedes over time, so there is less structure for the skin to sit on.
- Soft tissue descent. With less support, the tissue of the lower face moves downward.
The same review notes that outside factors speed these changes up, including sun exposure, general health, tobacco and alcohol use, and gravity. ASPS adds heredity and stress to the list.
That is why jowls appear at different ages in different people, and why two people of the same age can have very different jawlines.
Can creams or exercises get rid of jowls?
Creams have limits. The AAD says results from skin-firming creams are “subtle at best”, and that a cream or lotion cannot penetrate deeply enough to lift sagging skin. A product containing a retinoid, such as retinol, may produce a small change because it can help the body make more collagen.
We have not found reliable evidence that facial exercises remove jowls, so we do not recommend relying on them.
Non-surgical treatments for jowls
These are the main options. None of them removes skin, so each works best when sagging is mild to moderate.
Radiofrequency skin tightening
A device placed against the skin heats the tissue underneath. According to the AAD, most people have one treatment and feel some tightening right away, with the best results at about six months as the body makes new collagen. Some people benefit from more than one session, and results can last two to three years with good skin care.
The AAD describes the result of non-invasive tightening as “modest”. You can read how this is offered on our NuEra skin tightening page, and how it compares with surgery in NuEra Tight vs surgical skin tightening.
Microneedling with radiofrequency
Microneedling uses fine needles to create tiny, controlled injuries in the skin. Cleveland Clinic says this stimulates collagen and elastin and can improve the look of loose skin. It usually takes several sessions, three to eight weeks apart, and full results take three to six months to appear.
Some devices add radiofrequency heat through the needles. Our LegendPro RF microneedling page explains that approach.
Dermal fillers
Fillers do not tighten skin. They replace lost volume, which can smooth the hollow in front of a jowl and make the jawline look more even. The 2023 review says hyaluronic acid fillers suit mild to moderate loss of contour, volume and firmness, and that more severe cases may need surgery. It also warns against overfilling, which can widen the chin.
Fillers carry their own risks. The FDA says the most serious is accidental injection into a blood vessel, which is uncommon but can cause tissue death, vision loss or stroke. See our dermal fillers page for how treatment is planned.
Ultrasound and laser tightening
The AAD also lists ultrasound, which gives modest lifting within two to six months after one treatment, and non-wounding lasers, which usually need three to five treatments. Laser resurfacing tightens more than other skin-tightening procedures, but it needs five to seven days of downtime and carries a greater risk of side effects such as scarring.
What non-surgical treatment cannot do
The AAD states that even the more intensive skin tightening procedures “cannot give you the results of a surgical procedure like a facelift, eyelid surgery, or neck lift.” It adds that if you have a lot of sagging skin, skin tightening may not be helpful.
Cleveland Clinic makes the same point: non-surgical approaches might not be effective for extremely loose or sagging skin, and their results tend to be short-term compared with surgery.
If your jowls are pronounced, a consultation with a board-certified plastic surgeon about a facelift may be the better use of your time and money.
Who tends to get the best results?
The AAD says people are likely to get the most from non-surgical skin tightening if they:
- have a small amount of sagging skin;
- are at a healthy weight and maintain it;
- do not smoke;
- drink little alcohol;
- protect their skin from the sun and do not use tanning beds.
Skin tightening is not suitable during pregnancy, for anyone with a skin infection, or for people taking certain medications. Tell your provider about your full medical history.
Can you prevent jowls?
You cannot stop the changes in bone and fat that come with age, and heredity plays a part. You can limit the factors that speed up skin ageing. Sun exposure and smoking are both on the lists above, so daily sun protection and not smoking are the most practical steps.
Frequently asked questions
At what age do jowls appear?
There is no fixed age. It depends on heredity, sun exposure, smoking and bone structure.
How long do non-surgical results for jowls last?
It depends on the treatment. The AAD says radiofrequency results can last two to three years with good skin care. Fillers are temporary and are repeated when the effect fades.
Are non-surgical treatments for jowls safe?
The AAD says side effects of non-invasive skin tightening are usually limited to temporary redness and swelling, with little risk of other side effects when a board-certified dermatologist performs the procedure. Fillers have additional risks, which your provider should explain before treatment.
Next step
The right option depends on how much laxity you have and what is causing it. To have your jawline assessed and talk through what is realistic, book a consultation.
Sources
- American Academy of Dermatology. Many ways to firm sagging skin.
- Go BC, Frost AS, Friedman O. Using injectable fillers for chin and jawline rejuvenation. World Journal of Otorhinolaryngology – Head and Neck Surgery. 2023;9(2):131.
- American Society of Plastic Surgeons. Facelift surgery.
- Cleveland Clinic. Nonsurgical Facelift.
- U.S. Food and Drug Administration. Dermal Fillers (Soft Tissue Fillers).
Double Board Certified Nurse Practitioner
Beauté Medical Aesthetics
