Several factors, including heredity, stress, repetitive facial habits, and lifestyle choices, can cause more pronounced jowls at almost any age.
In this article, learn about exercises and treatments to get rid of jowls, as well as how to help prevent them.
The biggest cause of jowls is aging.
Though several factors are known to increase the likelihood and severity of jowls, their ultimate cause is aging.
As the skin ages, it starts to lose some of the compounds that help keep its shape, specifically fat and the connective tissue proteins elastin and collagen.
The skin also tends to become drier and thinner, making it more difficult to maintain its form. As the skin becomes less resilient and full, it becomes more vulnerable to gravity and slowly begins to sag.
Sagging skin around the cheeks and mouth falls to the area around the chin and jawline, creating jowls.
Risk factors for jowls include:
- history of sunburn
- excessive or chronic alcohol use
- chronic or severe dehydration
- chronic or severe stress
- diets low in antioxidants, healthful fats, and other essential nutrients
- habits or expressions that overuse the cheek, mouth, and jaw muscles, such as frowning, chewing gum, and talking on the cell phone for a long time
- skin allergens, ranging from air pollution to cosmetics
- poor skin hygiene
- lack of exercise
- cleansing the skin too aggressively
- physical trauma or injury to the facial and jaw muscles and skin
- a family history of jowls
- extreme or rapid weight loss
- severe or chronic illness
A history of sunburn may be a risk factor for jowls.
Some research shows that facial exercises, and exercise in general, can help reduce the appearance and severity of jowls by making the facial, jaw, and neck muscles better able to hold their shape.
A 2014 review concluded that while the statistical evidence is still weak.
However, all of the available studies exploring the effect of facial exercises on facial rejuvenation reported positive outcomes.
Exercise also significantly improves several factors that contribute to the overall health of the skin. This may help reduce the age of onset, severity, and appearance of jowls.
Any exercise that engages or stretches the facial muscles evenly without overusing them may help reduce jowls.
Most recommended exercises should be done one after another to ensure the facial muscles are worked evenly. People should hold each exercise for 5 to 20 seconds before releasing. Each exercise can be repeated 8 to 12 times, several times daily.
Common facial exercises that may help improve jowls include:
- Yawning and opening the mouth as far as possible, then closing it very slowly without letting the teeth touch.
- Puckering the lips outwards. This exercise works best when done lying down, and by using the fingers to draw the sides of the mouth downwards.
- Blowing the cheeks up as far as comfortable.
- Chewing with the head tilted slightly up.
- Grinning as widely as comfortable then slowly tilting the head up and down.
- Putting the lower lip on the top lip and tilting the head up.
- Lying down flat, curling the neck in towards the chest with the tongue pressing on the roof of the mouth.
- Humming with the tongue pressed against the roof of the mouth.
- Saying the sounds "o" followed by "e," using more force than usual and exaggerating mouth movements.
Jowls are usually harmless and do not require medical attention. But for some people, having severe or very noticeable jowls makes them feel uncomfortable, or causes them anxiety and lowers their self-confidence.
Medical treatment options for jowls are considered elective procedures or therapies, meaning most insurance companies do not cover them.
A dermatologist or plastic surgeon will usually perform jowl surgeries and procedures in a clinic or hospital setting.
Popular treatment options for jowls include:
Fillers are compounds that are injected into the cheeks to fill in the places where fat has been lost from the skin.
Lifting the cheeks also naturally lifts the skin around the jawline and corners of the mouth.
Fillers can also be injected directly into the jowl area to produce a fuller appearance. A 2014 study found that nearly 95.6 percent of people who received filler injections said they were "happy" or "delighted" with the results.
Compounds commonly used as fillers include:
- hyaluronic acid
- poly-l-lactic acid
- polymethyl methacrylate
- calcium hydroxylapatite
How long the effect of fillers lasts depends on the severity of the jowls, the structure of the face, the dosage of filler, and the number of injections given.
Many people find the results from facial fillers last anywhere between 2 and 4 years.
Fillers are typically more effective in people between the ages of 30 and 50. In people over the age of 50, additional procedures may be undertaken alongside fillers.
Popular brand-name injectable facial fillers include:
During most neck lifts, a surgeon will make a cut along the side of the face and under the chin, then reposition and sculpt fat and tissues in the jaw and cheek. They will also cut away some excess skin and tighten some of the surrounding muscles.
Neck lifts are widely considered the most effective treatment for jowls, but the surgery has a long recovery time and carries the most significant risk of complications. The most common complications are scarring and infection.
Neck lifts are also very expensive compared to other treatment options for jowls.
Ultherapy involves the use of ultrasound therapy to stimulate the long-term production of collagen in the deep layers of the skin.
Ultherapy only requires one session, and people can usually return to their everyday activities immediately after the procedure.
Most people notice a continual improvement in skin tightness and firmness several months after treatment.
In one study, nearly 70 percent of participants still saw improvements around their neck and jawline 3 months after the ultrasound therapy.
Radiotherapy uses intense, radiating heat to stimulate the bundles of collagen and elastin fibers about 2 millimeters (mm) below the skin's surface. This causes the bundles to recoil and the skin to tighten.
Radiotherapy also stimulates the production of collagen by tricking the body into thinking connective tissues have been damaged.
Many people need to repeat sessions a few times a year for maximum results.
The most common brand name of radiotherapy for jowls is Pelleve.
Additional treatment options for jowls include:
- laser therapy
- chemical peels
Less invasive alternative therapies are becoming more commonly used to treat jowls, but most require more studies to determine whether they are effective.
Additional therapies that may help treat jowls include:
Jowls may be prevented by staying hydrated and exercising regularly.
No one method can entirely prevent jowls, but some lifestyle choices can help reduce the severity or risk of early development.
Tips for preventing and reducing the severity of jowls include:
- staying hydrated
- wearing sunscreen with UVA and UVB protection
- wearing protective clothing during periods of prolonged or intense sun exposure
- using moisturizers
- using creams and lotions high in antioxidants that promote the production of collagen, such as retinol (a type of vitamin A), vitamin C, and vitamin E
- avoiding habits and expressions that cause the jaw and cheek muscles to face downward, especially chewing gum, frowning, and using the computer for a long time
- eating a healthful diet
- exercising regularly
- not smoking
- sleeping on the back instead of the side or stomach
- doing facial exercises that promote flexible muscles in the entire face
Almost everyone eventually gets jowls, but several factors can contribute to their development. Factors include damage, poor diet, repetitive facial motions, and sudden weight loss.
While jowls are harmless, some people may feel uncomfortable about how they look. Many medical options exist to treat them, including neck lifts, injectable fillers, and radiotherapy.
Less invasive alternatives are becoming more popular, as well. These include acupuncture, facial massage, and facial yoga. Regularly performing facial exercises may also help reduce the appearance and severity of jowls.