CheeksEyesForeheadLipsLower FaceNeck/DecolletageNose face


It’s hard to find anyone who loves their jowls or welcomes these floppy, wobbly additions when they manifest. I get more questions about jowls and how to treat and minimise them than most other topics. What are the answers? Here goes.




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What are jowls?

Jowls are the loose and fleshy areas of skin beneath the jawline which simply don’t exist when we are young, but which have a habit of creeping up on us with the years.

Why have I developed jowls?

Only because it is one of Mother Nature’s little gifts to us, that she dispenses over the years. As we get older, our skin becomes less firm, and so it has a tendency to sag. If we have a heavy face, with a decent amount of fat left in it (something we tend to lose with age), then gravity and the weight of the face helps to drag everything downwards. The same slackening is happening in the skin in our necks, and the result is that fat tends to slump under our jawlines and collect there, and it bulges forwards because the skin isn’t strong enough to retain it. It’s entirely natural, but it doesn’t make for a pretty picture.

Will losing weight get rid of my jowls?

This is a tricky issue. If you lose enough weight, it is bound to show up in your face as well as on your body. The trouble is, the results are unpredictable, and because of the way the fat pads in the lower face tend to slide south with age and gather unhelpfully beneath the chin, it is likely that your mid-face (where a bit more fat is helpful for padding out your facial contours; none of us likes to look gaunt) will start to show your weight loss before your jowls do. Even if you do lose weight evenly, there is no guarantee that your skin has sufficient elasticity to tighten up underneath the chin as you slim down, which could leave you with empty, sagging skin where the jowls used to be.

If your skin is still pretty elastic and your fat pads haven’t sagged down too much, you should see positive results just from losing weight.

How can I tighten loose skin under the chin without surgery?

There are several tweakments that you can try to tighten the skin on the neck without resorting to surgery. The key ones to know about are:

Injectable moisture treatments
These treatments are mostly about hydrating the skin from the inside—so they are not the first thing you would think of for tightening loose skin. There are several brands of these treatments and they all encourage ‘bioremodelling’ of the skin. This means the skin will regenerate itself and produce more of its own collagen and elastin, and become stronger, smoother and a little tighter, too.

Focussed ultrasound treatment
The power of focussed ultrasound treatments lies in their ability to send pulses of energy into the lower layers of the skin, to stimulate the growth of new collagen from well below the surface.

Radiofrequency treatment
Another tweakment that works by causing light damage to the subdermal layers, prompting a bout of collagen remodelling from within, is radiofrequency. Radiofrequency works by heating up the skin to the point—above 40°C—where the collagen becomes damaged. This damage shrinks the existing collagen, giving a small but immediate tightening effect. Following this, to try and repair itself, the skin produces more collagen, which helps strengthen, smooth and firm up the skin. A course of treatments will give the best results.

Which tweakments can shrink my jowls?

All the tweakments above will help with tightening the skin. If you want to go a notch deeper and look for treatments that can help fatty jowls, you could try a procedure that reduces fat stores under the skin, such as CoolSculpting or Facetite.

CoolSculpting is a fat-freezing treatment which destroys around 27% of the fat in the treated area. It is also proven to tighten the skin, which is helpful.

FaceTite is a treatment based on radiofrequency energy. It melts the fat beneath the skin, which is then extracted via a small cannula, so it is more invasive than most tweakments but can give remarkable results.

If you just have loose skin, you might find high-intensity focussed ultrasound or radiofrequency treatment work better.

What is the best procedure for sagging jowls?

The best procedure for sagging jowls is the one that will work for the particular way in which your jowls have sagged—and you will need a good practitioner to assess your face and discuss with you which treatment is most appropriate.

How much does CACI to tighten my jowls cost?

CACI is a treatment that uses electrical microcurrent to tighten and tone the muscles of the face and neck and it has a well-deserved reputation for being able to work miracles on floppy jowls – as long as you have enough sessions of treatment to re-educate your muscles. (I was told I would need 10-15 sessions.)
Here’s a video of CACI that I did for my Tweak of the Week series, which has loads of useful information:

Can I lift my jowls with Botox?

It might sound unlikely, but yes, you may be able to lift your jowls through carefully placed doses of a wrinkle-relaxing injection, such as Botox. I say ‘may’ because everyone’s jowls are different, and Botox won’t work for everyone.

Botox can help redefine the jawline because it is not so much a wrinkle-relaxing injection as a muscle-relaxing injection. A few well-placed jabs of toxin into muscles that are pulling the lower part of the jaw down, accentuating your jowls, will release these muscles and help redefine the jaw. Botox injections alone won’t totally resculpt your jawline, but they may well help.

Will the Nefertiti lift get rid of my jowls?

The Nefertiti lift is a fancy name for the procedure above, i.e. treating the neck and jawline area with Botox. So yes, depending on what your face and jowls look like to start with, this procedure may help. The aim is to give you a jawline and neck like the ancient Egyptian queen, who was renowned for her beauty. Here’s hoping!

What home devices can I use to tighten my jowls?

There are a number of home-use beauty devices that you can try in order to tighten up your jowls. The two that I think give you the best chance of success are:

  1. A NuFace facial trainer. This is a device that uses electrical microcurrents to stimulate the muscles beneath the skin. I would go for the NuFACE mini, which delivers the same power as its big sister, the Trinity, unless you particularly want to be able to try the other treatment heads available, in which case go for the bigger one.
  2. The TriPollar Stop – this device delivers radiofrequency energy into the skin, which heats the skin to the point that the collagen within it contracts (around 41°C). You’ll get a small amount of tightening from that, but the real result comes a couple of months down the line as the skin, shocked by the dose of heat, starts producing new collagen to counteract the damage that it has felt. The device is easy enough to use – the difficult part is that you will need to use it with dedication and put in the required number of sessions every week, and keep going until you start to see results.

What jowl exercises really work?

I’m not someone who has learned, and then practised, this sort of facial exercise and I don’t have jowls to practise on, so I can’t offer you any recommendations from personal experience.

But I know that many people do get great results if they dedicate enough time and energy to face exercises. And compared to the cost of tweakments, jowl exercises are a bargain, so if you have the inclination, they’re worth a try. Look for a regime that you can learn either one-to-one from a teacher, or from videos. These exercises can be tricky in that they involve moving muscles that most of us don’t realise can be moved. That is certainly the case for the platysma muscle beneath the chin, which is the one you want to be working to haul floppy jowls back into line. Look at the websites of these well-known facial exercise experts for instruction and inspiration: Eva Fraser or Face Yoga Expert or Studio Carme.

How to get rid of jowls with make-up?

If you’re going to try hiding your jowls with make-up, good luck! It involves some seriously clever contouring, artfully placing a darker shade of foundation or bronzer beneath the edge of your jaw to create the illusion of the shadow that a stronger jawline casts.

Can it be done? Yes, with a bit of practice—just take your foundation or bronzer and, with a small brush, buff it on just below the edge of your jaw, and under your chin. Bear in mind, though, that while this buffed-on shadow that you have created may look okay in pictures, or if you are facing people head-on, it may not look so good from the side. In fact, it may look as if you have a dark stripe of bronzer smudged under your jaw. Also, don’t do this if you are wearing a shirt or coat with a collar, because if you drop your chin and turn your head sideways, your careful handiwork will start to wipe itself off on that collar.


Alice answers your question. Want to ask Alice a question? Pop it in here and check back in a few days for the answer.

Hi Alice, could I please ask what your thoughts on threads are? I could do with some help with my jowls and under my chin. Many thanks! X

Hiya, editor Georgia here. Threads can achieve great lifting and tightening results in the right hands and providing you’re a suitable candidate. There are different types of threads and some are better suited to certain indications than others (e.g. the degree of skin laxity). You can also have bio-stimulating threads which help stimulate collagen within the skin, so you also get a gradual improvement in skin firmness. Threads are deemed 'minimally-invasive' but they aren’t for the faint-hearted, and things can go wrong. Plus, the results don't always last as long as advertised. It’s really important to find someone who knows what…

Monthly Hydrafacial or monthly Caci? I’m 43 with skin in reasonably good condition but starting to notice some signs of ageing, so planning to treat myself to a monthly facial.

Hiya, editor Georgia here. In an ideal world, budget permitting, you'd do both! HydraFacials are more geared towards extractions and hydrating the skin, improving surface issues like breakouts or dry skin. You do get some collagen stimulation from the LED light element but if your main concern is signs of ageing then I’d go for monthly CACI treatments instead. CACI is specifically for combatting signs of ageing by stimulating the facial muscles using electrical microcurrent. If you're new to CACI, you'll be advised to book a course of treatment and to have the first few treatments a fortnight apart. Find out more here.…

I was going to buy a Current Body LED face and neck mask. Is it worth the money? My skin looks good but I have a crepey neck and jowls. Thanks for your help.

I know a lot of people enjoy using these masks but I really don't think they're strong enough to make a noticeable difference to crepey skin – you need a clinic-strength LED light for that. You'd be better off with a skin-reconditioning treatment like injectable moisturisers, or in-clinic LED light sessions.

What is your honest opinion of Endolift? I have been recommended it for neck and lower face.

It's a really interesting procedure. If you take a look at the video of the Endolift treatment I had, you'll see there were improvements in the three-months-after 3D pictures – but they're not huge. Maybe I wasn't a good candidate for the procedure. I understand it works really well for recontouring fatty jawlines where people are looking for fat-busting plus the skin-tightening that the laser can give.

Hi Alice, I’ve just read your article on Profhilo – something I’ve been thinking of for a while. Everything I’ve been told says it helps with slackened skin, especially around the jowl area. Could you give me an opinion on this please? Many…

Hi Sue, yes all these injectable moisturiser treatments help smooth, strengthen and tighten the skin – but tightening is not their top USP, so unless you're very lucky, the tightening effect is fairly subtle. On jowls, it's not going to give you the sort of tightening you'd get from laser, HIFU, fractional radiofrequency, RF microneedling or Endolift, for example.…

Posting on behalf of my beautiful 65yo mum. Despite good skincare she has jowls, a drooping chin and a “turkey” neck. She has an autoimmune disorder, so Drs won’t do injections on her. What other tweakments could she look into, please?

When you have an autoimmune condition, tweakments aren't necessarily off the cards. Many practitioners are happy to treat patients with autoimmune conditions BUT they will want a thorough consultation with your mum first; it might be possible to have injectables such as filler at times when her condition is well under control (but not when she's had any flare-ups). Same for other treatments like radiofrequency microneedling, which can help with jowls and slack skin. Her best bet is to set up a consultation with a great practitioner in her area who will listen and talk her through suitable and safe options.…

Dear Alice, from what I can gather, I think you've had both radiofrequency with needling and also ultrasound treatments. My biggest problem area is my turkey neck and jowls. Which have you found to be the most effective treatment?

Hi, yes, I've had Ultherapy a few times over the past decade and it seems to have given me good results in tightening my lower face and neck, and more recently I've tried a couple of types of RF needling. The one that gave me the most obvious improvement was Profound RF, which is a hard-hitting, one-off RF needling procedure – there's a picture on my blog showing the difference it made to my jawline 3 months after treatment.

I’m looking to have a necklift – do you have any recommendations please?

Recommendations for specific surgeons would depend where in the country you are, but it may be worth first booking in with a cosmetic doctor to discuss possible non-surgical options before deciding on surgery. Find a brilliant practitioner near you here. And have a look at our page dedicated to crepey skin on the neck to find out more about treating this concern– depending on how lax the skin is, it may be that a course of injectable moisturiser or some skin-tightening tech like HIFU or radiofrequency is all you need.…

The fat from my cheek pads seems to have slipped downwards, making me look jowly. What is the best treatment for this?

Hiya, editor Georgia here answering on Alice's behalf. There are a few things you can do for jowls. If you suspect yours are more to do with fat rather than loose skin, I'd look into fat freezing with CoolSculpting (if the fat is beginning to group under the chin and around the jawline), or FaceTite. FaceTite is slightly more invasive as it involves extraction of the fat from under the skin with a cannula, but it can be very effective and only one session is needed. It first uses radiofrequency energy to melt the fat before sucking it away and leaving you with a more taught jawline. There are more options on our free Jowls factsheet,…

I have lumps under the surface of my skin (lower jaw area from Radiesse filler, which have become more pronounced. I have that this filler cannot be removed. Please can you advise?

Hiya, editor Georgia here answering on Alice's behalf. I'm sorry to hear this. You're right – Radiesse is a type of collagen-stimulating filler that can't be dissolved. How long ago did you have treatment? Lumps can occur immediately following injection but should settle after around four weeks. If it's been longer than this, unfortunately you'll have to wait until the filler is absorbed by your body, which can take up to 18 months. If they're really troubling you they can be surgically removed. I'd suggest following up with your practitioner and asking for a referral.

Hi Alice, I had Ultherapy after watching you have it! I went to Dr Victoria's clinic in Edinburgh...3 months later there is a subtle lift but wondering if I should try microneedling or fillers...it's the saggy jowls and tightening of the jaw.

Hi Becky, editor Georgia here answering on Alice's behalf. How long has it been since you had Ultherapy? Full results can take up to three months to be visible so you may wish you wait and see if you really do want to do something else. Having said that, yes – RF microneedling would be great to tighten up jowls and define the jawline a little more. You could have some filler along the jawline further down the line for extra definition, but fillers won't do anything for the jowls as such.…

Hi, I read your article in GH magazine and you recommended the Profound RF treatment, who did you see for this? Thanks

Hi, I saw Dr Sophie Shotter at her clinic in Kent (and one day I will get round to putting together an edited film to show the treatment). I was curious to try Profound RF because it's more intense than other types of radiofrequency microneedling so you only need one session. But meanwhile, there's a pic on this post showing the difference it made to my jawline three months after treatment.

I am considering Morpheus8 treatment. I am 59 my neck and jowls are very saggy. I have deep smoker's lines both above and below my lips. Would you recommend this treatment?

Yes, radiofrequency microneedling treatments like Morpheus8 are  great (though for saggy neck and jowls, they're not going to give you anything like the effect of a lower facelift). And yes it's good for treating those 'barcode lip lines' around the mouth. Have a chat with your practitioner and get their honest opinion on how much difference the treatment will be able to make for you - it will probably take three or four rounds of treatment. The other option that's fab for lip lines (and saggy skin and pigmentation) is laser.  …

I’ve been considering HIFU for my saggy jowls. If it ‘melts fat’ is this a bad thing? Surely it should tone and shrink the skin? Won’t less fat under my skin make things worse as the years pass? Less plumpness to sit on?

These are all great questions and this is what I struggle with when it comes to HIFU. Focused ultrasound energy absolutely has the ability to tighten and lift the skin which is what has made these treatments popular. But to do that, the focused energy needs to be delivered very precisely onto the collagen within the skin - to heat it, damage it and prompt collagen renewal -- and depending on whereabouts you're looking in the face, that depth can vary. If the ultrasound energy is focused into a patch of fat, it can heat, damage and melt that fat. Ultrasound is often offered as a treatment to do precisely this. Some facial ultrasound…


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