How to Treat Sagging Jowls With Filler

Learn how to treat sagging jowls with filler to rejuvenate the appearance of ageing patients for whom this is a common concern.

Jowl treatment is a great addition for aesthetics practitioners to master as it can be added to existing mid-face and lower face treatment plans. However, this is a challenging area to manage.

Our founder and aesthetics expert, Dr Tristan Mehta explains below what are jowls and the approach that provides the best results for jowl filler.

Dr Janine Rothburn, clinical trainer, aesthetics specialist and Harley Academy Level 7 graduate, also offers her advice on how to treat jowls. Plus, she shares her top tips for injectors and common mistakes to avoid.

You can also find details on the best aesthetics training courses if you’re looking to start learning or elevate your lower face treatments.

What are jowls and how do they develop?

Dr Janine states, “Jowls are described as sagging, loose skin around the jawline.

“There are various reasons why jowls can develop, but the leading cause is ageing. As we age, fat atrophy and volume loss occur, as well as loss of collagen and elastin. This results in skin laxity which contributes to the formation of jowls.”

Dr Tristan Mehta offers a demonstration of the different layers of the skin involved in jowl formation in the video below.

Treatment for sagging jowls: approach & techniques

Jowling can be treated with dermal fillers either directly or indirectly.

Using fillers to manage jowling

As this is a lower face concern, most of the time, indirect treatment is the first stop. This is because it softens jowls, while you rejuvenate the midface. Direct treatment is usually later in the treatment plan.

Treating the mid-face to soften jowling

Dr Janine explains, “Restoring volume loss to the mid-face will indirectly soften the jowls. This is achieved by injecting hyaluronic acid-based fillers into the cheeks, to add volume and create a more lifted appearance. This will help to reduce the appearance of the jowls and improve the contour of the jaw.

“A combination approach of mid-face and lower-face filler is a fantastic way to tackle the jowls.”

The lower face approach

Jawline contouring is also worth considering when forming a treatment plan for this concern, adds Dr Janine. “A firm high G prime filler is recommended to provide structural support to the lower face supraperiosteally. A 25G cannula in layer 2 with a high G prime filler, to treat the pre-auricular region and posterior jawline can also help to soften the appearance of the jowls.

Direct jowl filler treatment

Dr Janine highlights, “One approach to treat the jowl area directly is injecting the pre-jowl sulcus and the gonial angle. Adding volume to these areas will improve the contour of the jawline.

"Techniques will vary between practitioners. I will often use a 27G needle onto periosteum to the pre-jowl sulcus and gonial angle.”

If you struggle with administering lower face treatments, our Cheek, Mid & Lower Face Filler Masterclass targets areas including the jowls. During this day-long Masterclass you’ll learn about the effects of ageing on these regions and how to combine treatments for rejuvenation. Furthermore, you’ll learn about various needle and cannula techniques.

Non-injectable options to prevent and treat sagging jowls

Injectables are a great option for treating sagging jowls. For less advanced cases Dr Janine advises, “Non-surgical skin tightening treatments are also effective ways of treating the jowls. These treatments include:

• Radiofrequency microneedling
• Ultrasound devices
• Laser devices.”

She explains, “Such treatments stimulate collagen and help to tighten the soft tissue envelope. This will soften the jowls and create more definition to the jawline.”

As an aesthetics practitioner, you must assess a patient properly and offer them multiple treatment suggestions based on your knowledge. Combining skin treatments with injectables offers a holistic approach to their treatment plan, targeting multiple aesthetic concerns. This is the approach we recommend and teach on our Combined Level 7 course.

Surgical treatment options

For more significant cases, Dr Janine suggests considering referring your patient for a surgical facelift or lower facelift. She notes, “This will lift and tighten the skin around the lower portion of the face, reducing the appearance of the jowls and improving the jawline contour.”

How long do jowl filler treatment results last?

Dr Janine notes, “The filler's longevity will vary from patient to patient. Individuals can generally expect results to last a minimum of 12 months.

“The more we learn about dermal filler, the more we discover that it lasts longer in the face. Skin quality, product used and metabolism can affect the longevity of the results.”

Avoiding common mistakes

Dr Janine states, “A mistake aesthetics practitioners make when attempting to soften the area is placing filler in the jowl fat. This is a ‘no-go’ zone and will create an even heavier appearance of the jowls.

“Another mistake that injectors make is not treating the mid-face; treating the mid-face can often appear to ‘lift’ the lower face and help to soften the jowls.”

Managing patient expectations is also key. Jowls are a big concern for ageing patients, but are challenging to treat. Understanding the patient's concerns and being realistic about the outcomes that can be achieved will stand you in good stead from the start.

Develop your treatment offerings through aesthetics training

If you’re looking to develop a deep understanding of injectable treatments, our Level 7 Diploma in Botox & Dermal Fillers offers a comprehensive approach.

Open to doctors, dentists, nurses and clinical pharmacists, you can start our Ofqual-regulated Level 7 Diploma straight away - you don’t need to have completed any type of filler or botox training courses previously. It can take you from total novice to aesthetics specialist status!

Made up of self-paced eLearning and one-to-one mentoring, our Master’s-level injectables course allows you to complete your aesthetics training at a pace that works for you. You’ll get first-hand experience of life in a working clinic at our City of London campus, treating your own patients that we source.

Book a FREE 15-minute discovery call with one of our Course Advisors to find out which aesthetics training route is best suited to you.

All information correct at the time of publication