Goodbye, Double Chin: Here's How To Combat Sagging Jowls

BY Dr. Shawana Vali / Nov 1 2018 / 15:54 PM

Sharpen your selfie game as cosmetic dermatologist to the A-list, Dr. Shawana Vali, discusses the J-Lo jawline and how to keep jowls at bay

Goodbye, Double Chin: Here's How To Combat Sagging Jowls

The Problem : Saggy Jowls

Your jawline is one of those things you probably take for granted. Like shoulders and wrists, it’s not something that ever needs to be squeezed into Spanx or covered with sleeves; it’s just not a problem area. Until one day, probably around your late 30s, when it is.

I, partly, blame Snapchat. The facial filtering tool hones our skull’s silhouette to Disney Princess proportions, giving us the look of a baby deer. But then you flick that filter off only to find Shrek staring back. Let’s be honest, it’s not like we need another body part to fret about, but once you’ve noticed the increasing accumulation of soft flesh around the outer edges of your mouth, slowly spilling down your neck, there’s no coming back from the sense of impending doom. Firstly, you (and by ‘you’ I mean your medical practitioner) need to identify the cause of the sag. Culprit number one is skin laxity, which can be a result of genetics, inflammatory skin conditions such as acne or rosacea causing your skin to age faster, or damage caused by smoking or sun exposure. If your skin is lax, the deeper anatomical structures of your face simply won’t be held in place.

The second offender is one that gets us all eventually: gravity. As we age our facial fat pads migrate downwards, causing heaviness and loss of definition in the lower third of the face. This means pre-jowling and the dreaded jowls.

The Solutions: Creams, Machines and Dreams

Fortunately, help is at hand. If you’re suffering from lax skin, vitamin A-derivative creams, such as Tretinoin and retinoic acid, will stimulate the fibroblast, or the building blocks of the skin, fixing you from the inside out. To camouflage, rather than treat, a soft jawline, hyaluronic acid fillers can contour and mask the jowl by defining the jawline. Just be careful of your doctor trying to lift jowls by overinflating your cheeks with dermal fillers. Adding volume to your face or reducing muscle movement with Botox isn’t going to correct the underlying issue and will just distort your features.

To stimulate collagen production, your practitioner may suggest machine-based treatments including radiofrequency, ultrasound, fractional micro-needling and lasers. This can be a good place to start if you have only a small amount of laxity. However, the results from all devices depend on getting even penetration of all cells. The effects from machine-based treatments are temporary and can result in more laxity if inexpertly applied. It’s also important that machines are not used to remove fat pads as these are essential to skin support. If you have more advanced sagging, machine-based treatments will not be enough to make significant changes to your jowls.

Beauty PrescriptionUplift roller by Nurse Jamie, Dhs2,830 at Net-a-Porter

When it comes to fat-pad migration, I like to use a thread lift; a non-surgical face lift that delicately adjusts your facial architecture. A fine thread is inserted into the skin and gently tugged upwards to persuade falling fat pads back into their original positions. The threads stimulate collagen production that holds the fat pads in place, and then naturally dissolve. I love this approach because it allows me to treat several facial planes to achieve a perfect result for every face, unlike a traditional face lift, which acts mainly on the sides of the face. Plus, it doesn’t add any volume to the face. The procedure needs to be topped up every few years. Finally, if you’ve tipped into bulldog territory, with jowls extending down to the neck, a traditional face lift is likely to be the best solution.

If you want to hold off on going under the knife there are lifestyle changes that will help. It’s important to try and keep your weight stable, as fluctuating weight gain or loss can be disastrous for facial skin as you are inflating and deflating the fat pads like balloons, which results in stretching your skin out. This is why it’s really difficult to lose weight from under your chin after your mid 30s because it will result in the dreaded turkey neck.

So-called runner’s face is a myth, in fact exercise improves your skin by increasing blood circulation. However, if you are an avid runner, make sure you always wear sunscreen and a hat. Finally, train yourself to sleep on your back. Sweet dreams!

Beauty PrescriptionDr. Shawana Vali


When you’re in your thirties and do not have much sagging, lighter non-invasive treatments such as radio frequency skin tightening, laser, infrared and carboxytherapy might be all that you need.

You may need to start considering more robust treatments, such as thread lifts.

If you have a significant amount of sagging you may want to opt for a traditional face lift to see the results you’d like. However, everyone is different, it all depends on genetics, skin quality and previous history of skin disease.

From the October 2018 Issue of Harper's Bazaar Arabia