Ask The Expert: Jowls

This month we're introducing a brand new feature to the Woodlands blog: Ask The Expert! If you've got a  burning question related to anti-ageing or aesthetic treatments, why not email it to us on

Every month, we'll choose a question and a member of our aesthetic team will answer it! We're starting off with our lovely Aesthetic Nurse Practitioner, Saria...

Question: I’ve noticed that the skin around my jawline is sagging and I’m starting to look a bit “jowly”. I’m not ready to go down the route of surgery, so I was wondering what else could be done to improve this?

Saria: Well, the first thing to remember is that before we can recommend any treatment for you in clinic, we’d need to see you in person and conduct a full medical consultation. This would allow me to assess your face, find out a bit more about your medical history and lifestyle and also discuss with you the results you’re hoping to achieve. Once we’ve done all of that, we can move on to talking about the different treatment options available and which treatment(s) is going to give you the best results.

Jowls and sagging skin on the face are usually caused by either very rapid weight loss, or, more commonly, the ageing process. As we age, we lose a large portion of the fat in our faces and our skin loses its elasticity, meaning that everything drops. We often talk about “loss of volume” in aesthetics; this is literally where the face loses its fullness due to ageing. Compare photos of yourself ten years ago to how you look now and you’ll most likely notice your face, particularly around the cheek area, looking much more full than it does now.  It’s this loss of volume that is generally why we start to notice the overhang of skin around the jawline, commonly referred to as jowls.

When we’re looking at how to treat loss of volume in the face, our first port of call is normally dermal filler. We basically want to inject dermal filler into the areas that the volume has been lost to essentially “fill” that area out again and lift the skin back to where it was originally. Even though the actual area of concern is the jawline, sometimes the best area to treat will be the cheeks, because adding volume to this area will improve both the mid and lower face. We generally use one of the heavier hyaluronic acid fillers for a procedure such as this, as these are better suited for creating support underneath the skin. There are several fillers which are specifically formulated to restore lost volume and the results with these fillers can last up to eighteen months.

Depending on how pronounced the sagging along the jawline is, we may also recommend injecting some filler actually along the jaw itself, to tighten the area and add definition. To do this, we will make several small injections along the jawline, manipulating and sculpting the dermal filler as we go. We may use an aesthetic cannula for the injections, rather than a needle, as this allows us to be more flexible and follow the natural shape of the jawline to place the filler exactly where we want it to go.

An alternative treatment for sagging skin and tightening the jawline is a thread lift. This is a slightly more invasive procedure than dermal filler that uses specialised threads which are inserted into the skin and then pulled tighter to lift and tighten the skin. The threads are made from a substance called polydioxanone (PDO), which eventually dissolves after several months, however, because it stimulates collagen and elastin production in the skin, the results from a thread lift can actually last up to two years. There are several different types of threads that can be used for this procedure, including cogs, which are a longer, thicker thread covered in barbs. These barbs help to secure the thread in place once it has been inserted into the skin. The treatment is done using local anaesthetic in order to ensure that the patient stays comfortable throughout. There is no downtime, however, as with any injectable procedure, there is a risk of bruising and swelling afterwards.

If you would like to find out more about any of the treatments mentioned in this blog, or to discuss any other treatments offered at Woodlands Medical, you can book in for a free consultation with myself or another of our aesthetic practitioners by calling 0151 728 2536.