March 26th, 2025
Dr. Mulholland, Md
Looking into the mirror and noticing the signs of aging is rarely met with optimism, especially when they begin to show at an age we deem too young.
For many, losing their tight, smooth jawline to sagging skin is not only the first sign of aging they notice; it’s also the most noticeable. This area of loose skin is what is known as a jowl.
If you’re wondering how to prevent jowls, how sagging jowls form, to begin with, or what you can do to treat jowls after they appear, Toronto Plastic Surgeons Centre has the answers. But let’s start with the most basic question: what are jowls?
What Are Jowls?
The official jowls definition refers to when we talk about sagging and excess skin around the neck. More specifically, the skin around the cheeks and mouth droops down to the chin and jawline.
This typically occurs due to the natural aging process. As we get older, our bodies slow the production of collagen and elastin, which are required for the skin’s ability to stretch and bounce back, as well as to stay soft and supple.
As the connective tissues and facial muscles that keep your skin nice and tight to your face begin to weaken, paired with reduced skin elasticity, the combination causes the skin to droop, creating saggy skin.
The worst part is, when we say this is part of the aging process, it doesn’t begin when you’re already old—not even close! Collagen production slows down as early as our 20s, and jowls are often among the first to show signs of aging. Many of our patients have reported noticing visible sagging jowls as early as their 30s.
Other Causes of Jowls
Besides the natural progression of time, many other lifestyle factors can cause or further define sagging skin and its appearance, including the following:
- Sun damage
- Overconsumption of alcohol
- Chronic smoking
- Extended dehydration
- Looking down for long periods at a time (working at a computer, for example)
- Severe or constant states of stress
- Poor diets lacking antioxidants and healthy fats
- Repetitive facial habits and facial expressions involving the cheek, mouth, and jaw areas (chewing gum, extended talking)
- Allergies and poor air quality (pollution)
- Improper skin hygiene and lack of skincare, such as moisturizing
- Poor exercise habits
- Family genetics
- Extreme or sudden weight loss resulting in loose skin
- Some illnesses or conditions that may cause skin quality changes
How Can You Prevent Jowls?
Often, the formation of a jowl is out of a person’s control, especially if the jowls are caused by aging and genetics. However, if you’re wondering how to reduce sagging jowls, there are steps you can take to minimize their appearance and improve skin laxity.
Suppose you find yourself guilty of many of the above-listed items, such as smoking, excess drinking, and poor dietary habits. In that case, cutting down on these poor habits while staying properly hydrated will not only help prevent sagging jowls but also slow the effects of aging throughout your body.
Working with your face down for long periods can increase gravity’s pull on your skin, so maintaining an ergonomic setup that keeps your head level or slightly reclined is beneficial.
In terms of skincare, keeping your skin moisturized will help prevent it from drying out and, in the long term, can slow the appearance of aging. Some find that treatments like chemical peels or skin-tightening creams can help stimulate collagen production and reduce the appearance of jowls. However, these do not work for everyone.
Our Treatments for Jowls
Preventative measures can sometimes only take you so far in preventing the formation of jowls. When these methods no longer do the trick, our clinic has many options to help you to get rid of jowls and enjoy a more youthful appearance.
Neck Lift
Platysmaplasty, more commonly known as a neck lift, is a cosmetic procedure that helps reduce signs of aging in the jaw and neck, including jowls. A neck lift is done by making an incision along the sides of the face and under the skin. The skin is then repositioned, and fat in the jaw and cheeks is sculpted into place. On some occasions where fat may be limited, facial fat grafting will be applied here to achieve a fuller effect. Any excess or sagging skin is then removed, and the muscles in the area are tightened.
This results in a far smoother, tighter appearance, giving a streamlined jawline vs. having sagging jowls. Neck lifts are often considered the most effective treatment for combatting sagging jowls and can be paired with other facial procedures.
Facelifts
A facelift can remove years, even a decade, from a person’s face. As such, they are among the most popular procedures we perform to treat signs of aging, such as brow drooping, wrinkles, and, of course, sagging jowls.
Our clinic offers several types of facelifts, varying in complexity and the areas of the face treated, based on a patient’s individual needs for tightening loose skin.
Mini Facelift
Let’s start with the least invasive facelift surgery options for treating jowls. The mini facelift is a minimally invasive procedure that targets the lower face. This is done by making small incisions around the ears and treating areas of concern, such as fine lines and wrinkles, as well as sagging skin in the lower face, including the jowls. We often perform fat grafting during this procedure to enhance cheek fullness and help your face look younger for years to come.
As previously mentioned, this is a far less intensive surgery compared to other facelifts and is not recommended for those with more severe signs of aging. Instead, the ideal candidate for a mini facelift is someone who shows no visible signs of aging, such as deep lines and wrinkles, and only needs to address specific issues, such as sagging jowls, cheeks, or mouth lines.
This procedure is often favoured by younger patients in their 30s and 40s, who do not yet require the work of more intensive facelift procedures but wish to treat the presence of a jowl. Those who require further work may instead need a full facelift.
Mid Facelift
This procedure is sometimes known as a cheek lift. As the name suggests, this facelift targets the midsection of the face.
While not addressing the upper face, the mid-facelift targets the areas around the eyes, nose, and cheeks. Incisions are made, the skin is smoothed, and fat can be repositioned and added to the cheeks during this procedure to achieve a more rejuvenated, youthful appearance. Having higher, fuller cheeks can help prevent the skin from dropping down and contribute to sagging jowls.
Full Facelift
Our clinic offers two types of facelifts to address jowls: the deep-plane and the SMAS facelift.
Deep Plane:
A deep-plane facelift is considered the most extensive type of facelift procedure. During a deep-plane facelift, incisions are made in the face that extend to deeper levels than in other facelifts, reaching deeper muscle layers. Being able to perform on deeper levels of the face allows for a stronger manipulation of the underlying tissue. These tissues and muscles are then tightened very carefully to avoid damaging exposed nerves and muscles. The fat in the face is then repositioned to achieve a fuller appearance, and the skin is smoothed.
SMAS:
SMAS stands for “Superficial Musculo-Aponeurotic System”. This refers to a layer of connective tissue that covers areas of the face and neck; it is one of the primary support structures that help define the shape of your face. By targeting and repositioning this layer of tissue, signs of aging, such as sagging jowls and deep smile lines, can be addressed.
TPS offers both women’s and men’s facelift procedures.
Liposuction
Liposuction can be performed all over the body, from the stomach, legs, arms, and even the face.
Fat deposits forming and building up around the cheek, chin, and neck area are very common. These stubborn pockets can be difficult to eliminate, even with a proper diet and exercise, and may require liposuction for effective removal.
Facial liposuction is a minimally invasive cosmetic procedure that can effectively remove stubborn fat cells in the face.
Facial liposuction is commonly performed alongside other procedures such as facelifts, neck lifts, blepharoplasty, and fat grafting. The cost of liposuction varies depending on the area and complexity of the procedure. Pricing generally starts at $6999. For men’s liposuction costs, check out this page.
Facial Fat Grafting
Also known as a fat transfer, fat transplant, or microsculpture fat graft, this procedure involves taking fat from a donor area on the body, usually where the patient has unwanted fat, such as the thighs or abdomen. The fat and stem cells are then relocated to the desired area in the face. This can be used to lift cheekbones, fill out hollowed cheeks, and effectively treat jowls.
Fat grafting is an appealing option for many patients with several benefits. First of all, many patients appreciate that the fat is natural and comes from their own body, rather than involving a foreign injectable. Unlike other fillers, fat transfers are also long-lasting and rarely need to be “topped up” as long as the patient remains in reasonably similar health to when they had the procedure. Larger volumes can be transferred here as well, versus other injectables, for more substantial results.
Lastly, many patients enjoy this option because it is a “2 in 1” procedure. The donor area undergoes liposuction to harvest fat, which can help slim the area and improve overall body contour.
Dermal Fillers
Injectable dermal soft-tissue fillers are an alternative to facial fat grafting and can achieve similar results. There are several dermal fillers, such as Juvederm, Revanesse, and Teosyal.
Since jowls result from a lack of volume under the skin, these fillers work as a preventive treatment by filling them in, as the name implies. Fillers work to lift and hold the skin in its original (or better) condition by being injected into areas where fat deposits are depleted.
Many prefer this method to treat jowls, as it does not involve surgery, unlike fat grafting, which requires surgical donor liposuction. As this method is non-surgical, there is far less bruising or swelling after the procedure. This method is also far cheaper than other options, with prices ranging in the hundreds rather than thousands.
However, a drawback of receiving dermal fillers to treat jowls is that fillers are not a permanent solution. Unlike other procedures, such as facial fat grafting, fillers only last a few months (roughly between 9-14 months) before they begin to wear off and require further applications.
There are a few advantages to using these dermal soft tissue fillers to prevent a jowl from forming:
- They do not require a fat donor site to be taken from to inject.
- They often provide less facial swelling and bruising after the procedure.
- An often appealing effect is that results are immediate.
However, unlike facial fat grafting, where the cells can survive for many years, gel dermal fillers only last about 9-14 months before wearing off and require reapplication; otherwise, the appearance of the jowl may return. However, those nervous about receiving work done may find this beneficial as a way to “try out” a cosmetic procedure to treat their jowls before committing to a more permanent solution.
In Closing
Whether you’re looking for sagging jowls treatment, reducing the look of facial wrinkles, or removing the dreaded double chin, we can help you.
Our clinic combines top-level surgeons with decades of expertise and state-of-the-art equipment to ensure your surgical or other procedures are as good as they can be.
So if you’re ready to say goodbye to those sagging jowls or just want to know more, please give us a call at 647-723-3739, or book a consultation through our website to get in touch with a member of our excellent team, and we’ll guide you through everything you need to know.
Dr. Stephen Mulholland, Md
Dr. Stephen Mulholland has been practicing plastic surgery for over 20 years. He is one of Canada’s most renowned and best plastic surgeons in Toronto with his wealth of experience, artistry, and humbleness towards his patients.
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