Why am I getting jowls?

We hear this question a lot from our patients. The truth is, there are several factors that contribute to the development of jowls. Below you’ll find all you need to know about the formation of jowls, along with how to prevent them – or treat them.


LOSS OF COLLAGEN AND ELASTIN

The term, “jowls,” is commonly used to describe saggy skin below the jawline. One of the primary causes of jowl formation is the development of thinner, less elastic skin which occurs because of collagen and elastin loss in the skin. As these vital proteins are lost, the skin around the cheek and mouth loses its firmness and tightness. Gravity then causes it to sag fall to the area on either side of your mouth and chin often extending below the jawline. 

I’m sure you have all heard the terms collagen and elastin used in your lives to discuss anti-aging and beauty treatments. Collagen is a protein that makes up the connective tissue in our bodies. Elastin is another connective tissue protein that lets your skin return to its normal shape even after being stretched. I always tell patients to think of collagen as the pillow top on their mattress and elastin as the springs. No one wants to sleep on a smooth pillow-top with a sunken spot in the middle, nor does anyone want to sleep on springs alone. We need both! 

GENETICS AND AGING CAUSED BY SUN EXPOSURE

As with most physical features, genetics and aging play a role in how quickly we lose facial volume and where we lose it from. Look at images of your mothers, grandmothers, and even aunts and siblings. Do you notice any similarities between the areas that are bothering you and their own facial features? If so, genetics are probably partially to blame. 

Aging is inevitable, and gravity exists. Since we can’t combat gravity, and we know that birthdays will just keep coming, we focus on minimizing the unwanted effects of these two existing causes of volume loss that can result in jowling. Anti-aging skincare regimens, like those customized using ZO Skin Health and Alastin products, will help prevent and reverse the most superficial signs of aging. SPF is always mandatory in these regimens as 90% of age-related changes are caused by sun exposure. 


HOW DO I REPLACE COLLAGEN AND ELASTIN?

At The MAC, we take a multi-step approach to restoring collagen and elastin in the skin’s tissues. This process includes two main ingredients, procedures, AND skincare. We carry two skincare lines. One of them is called Alastin, creatively named for its unique ability to restore the snapback factor of our skin, elastin. In addition to working on elastin, their products contain a patented formula that clears out broken down collagen and elastin fibers and their byproducts to make room for and stimulate new collagen and elastin growth. That’s incredibly impressive for a product that is only applied topically. 

As far as procedures go, we have numerous collagen stimulating procedures, from Sculptra injections and Broadband light therapies to ReLift’s radiofrequency and thermal tightening action and SkinPen’s collagen induction therapy. One of our favorite procedures is Sculptra injection. This FDA approved treatment, induces massive amounts of collagen production in the facial tissues. While treatments like SkinPen works more superficially on the skin, Sculptra works deeper in the dermis to essentially ‘re-grow’ lost collagen and ‘lift’ the tissues back to their proper place. More to come...


WILL FILLER FIX MY JOWLS?

Speaking of lifting things back to their proper position, that brings us to our next point. A combination of Restylane Lyft and Sculptra Aesthetic is one of the best procedures we could perform in the midface to restore volume loss beneath the dermis of the skin and subtly ‘lift’ the tissue back up. 

Rather than filling the lines that are bothering you around your nose, mouth, and chin thereby causing your face to look heavier or more square, we seek to replace the volume from top to bottom resulting in a more heart-shaped or feminine appearance. You may have heard some of this in our previous blog called, “5 Reasons You Will Love Our Newest Filler: Sculptra.” 

In that blog, we discussed not only the unique safety profile of Sculptra Aesthetic but also the areas most commonly injected including the temples, the nasolabial folds, and the area below the cheekbone but above the jawline that hollows out when you make a fish face. (I know you just tried it LOL.) By restoring volume in these areas, we see a lifting of the drooping or sagging skin of the lower face. 

Where does Restylane Lyft come into play? Lyft is most often used in the cheek, chin, and jawline to give a more contoured appearance to these areas. In the case of a patient with jowls, we place it directly on the bone of the mid-cheek to replace the much-desired fat that we lose in this facial compartment. Because Lyft is placed directly on the bone in this area, it appears very natural and provides a lifting effect to the nasolabial fold and skin below the cheekbone but also supports the undereye or tear trough area. 


THE BEST WAY TO TREAT JOWLS

Generally, a combination approach using Sculptra Aesthetic and Restylane Lyft coupled with superficial skin support from ZO and Alastin results in a natural-looking improvement of mild to moderate jowling. In addition to this recommendation, the MAC offers several other treatments that can help improve the appearance of the mid and lower face.