Jowls describe the loose sagging tissue below the jawline caused by a loss of volume of deep fat pads in the middle portion of the face, exacerbated by the loss of collagen and elastin in the skin of the lower face. They affect both men and women and usually appear in middle age. Their severity depends highly on genetics, bone structure and lifestyle (smoking, sun exposure, etc.). Many patients find that their jowls make their lower face look heavy and their jawline no longer defined. 

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Dermal fillers may be used to restore volume in the midface and add volume around the jowling tissue to camouflage it, straightening the jawline. Another option, used mostly in early and mild jowling, is the use of a neuromodulator (botulinum toxin, BOTOX®) to relax the platysma muscle of the neck which pulls the skin of the lower face down. 

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