Understanding Jowls and Their Management

For many, jowls refer to that loose skin hanging below the cheeks and along the jawline. They can be one of the first signs that aging is setting in, which can be quite a surprise.

Dr. Shereen Idris, a board-certified dermatologist and founder of Idris Dermatology in New York City, shared her insights about managing what she calls downward “drag.” To explain why jowls appear, she often uses a furniture analogy.

“Think of facial aging like a sofa: the bones are like the frame, the fat and muscle serve as cushions, and the skin is akin to the fabric,” she suggests. If you begin to notice the early signs, it’s rarely just about the skin itself. Instead, it’s usually a mix of losing structural support and gravity pulling fat downwards.

As the “sofa” frame changes and the cushions begin to compress, the skin inevitably starts to sag, adapting to these changes.

Despite the multitude of non-invasive treatments available, she stresses that success doesn’t come from a magic remedy. It requires a thoughtful, layered approach.

“It often feels like it happened overnight, but it’s really the result of years of collagen depletion and tissue movement,” she explains.

While there are many jaw-contouring tools on the market, Idris advises patients to manage their expectations when trying them out. Facial rollers, for instance, might help with temporary swelling but won’t truly get rid of the jowls themselves.

She also cautions against opting for buccal fat removal—a trendy procedure that eliminates natural fat pads in the cheeks to create a more chiseled appearance, believing it might not yield the desired results.

When it comes to addressing jowls, removing fat can sometimes lead to quicker development of sagging, which is concerning. The goal should be to maintain one’s facial “cushion,” rather than discard it.

Surgical solutions, such as facelifts, come with their own limitations. While they can reposition and tighten skin, they do not address the deeper changes that accompany aging.

Idris emphasizes that changes can sometimes feel sudden, particularly during specific “peaks of aging,” like in the mid-40s. These feelings might seem abrupt, but they’ve usually been building over time.

If you’re in your 20s or 30s, it’s wise to focus on preserving your facial structure before those cushions start to sink. This means regularly using sunscreen, applying retinoids for added skin benefits, and aiding collagen protection through inflammation management.

Nevertheless, she reiterates that the emergence of jowls isn’t due to skincare mishaps. “It’s fundamentally linked to your bone structure,” Idris points out.

Ultimately, experts agree that the objective should be tackling the foundational causes of sagging rather than pouncing on fleeting trends. “Less is generally more,” Idris cautions. “Too much treatment can lead to results that appear unnatural.”