What are Jowls?
Jowls – the annoying sagging skin/ fat that hangs along the lower face and jawline. Why do we have them and what can we do about them? Jowls can be the result of many different factors, with age being the primary cause. However, several factors can cause jowls to develop faster, such as genetics, facial expressions, weight loss, sun exposure, smoking, and use of computers or phones. All of the factors listed above have a direct impact on the loss of collagen and elastin, which can contribute to a heavy looking facial shape. In this post, we will explore why jowls happen and how they can be treated, including with something as simple as a 30-minute toxin appointment.
With age, we lose collagen and elastin in the cheeks and around the jawline. Why are collagen and elastin important? Collagen is a protein that makes up the connective tissue in the body. Elastin is another type of connective tissue that helps with skin snap back. Think of connective tissue as the glue of the body.
Jowls can also be the result of genetics. Genetics can determine a lot of the physical changes we experience as we age, and the jowls are no exception. If either of your parents have jowls, it is likely that you will develop jowls.
Sun exposure, which is pretty much unavoidable in Arizona, can also be a contributing factor to jowl likelihood and severity. Sun damage accelerates the break down of collagen and elastin (Picture A). With the premature loss of connective tissue, the skin is more prone to sagging from the lack of facial tissue support. The best defense against the sun is to limit exposure, wear medical grade sunscreen and protective clothing.
A: Image of man who was a truck driver for 28 years.
Sun damage on driver side of face.
Credit: New England Journal of Medicine
Whether its age, lifestyle, or genetics, once our collagen and elastin supplies become compromised, so does the fat in our cheeks. Not only do we lose fat, but the fat pads that we do have slide down and forward, due to the loss of connective tissue (Picture B). With a decrease in facial tissue support, our skin becomes thinner and does not have the snap-back that it once had.
B: Depletion of fat pads & connective tissue.
Now that we know the many contributing factors that cause jowls, what can we do about them? The muscle underneath the jowls is called the platysma. The platysma basically acts as a turtle neck starting at the jowls/jaw line and extends down to the collar bone (Picture C). As we age, the platysma and the muscle under the jowls (depressor anguli oris) stretches the skin down and out. This is sometimes referred to as “turkey neck” and is the result of the platysma contracting, creating bands (Picture D). Accentuated platysmal bands can also be the result of clenching or stress.
C: Platysma muscle
D: Before having platysmal bands treated vs.
two weeks after.
For patients who have mild sagging of the jowls, toxin can be injected into the jowls and platysmal bands to help relax the muscle, which helps give the jowls a lift. If a patient has a history of clenching, it would be recommended to treat the masseter muscle, which can further help lift the jowls and sharpen the jawline.
Once the toxin settles in, patients will notice the corners of their smile are slightly turned up, the chin no longer has an orange peel look and the jawline and neck appear sharper. Think of toxin as shapeware for your neck and jowls. If a patient has excess fat in the jowl/neck area, or moderate sagging, Kybella, Coolsculpting, or a skin tightening treatment may be the best place to start.