As we age, one of the most noticeable changes in our skin involves the loss of firmness in the lower face. Jowls and sagging skin along the jawline, neck, and upper face can make us look older and more tired than we feel. Fortunately, modern aesthetic treatments offer a range of effective solutions to address these concerns, from surgical procedures to cutting-edge minimally invasive treatments depending on each person’s goals.
In this post, our board-certified New York City aesthetic plastic surgeon explores the causes of sagging skin and discusses top surgical and non-surgical treatment options to restore a smooth, youthful contour in the lower face, upper face, and neck.
What Causes Sagging Skin?
Sagging skin and jowls, which refer to hanging skin along the cheeks and/or jawline, typically result from a combination of factors, including:
- Age-related loss of collagen and elastin: These structural proteins provide firmness and elasticity to the skin. Natural production of collagen and elastin fibers starts to decline over time, leading to looser skin.
- Volume loss: When the fat pads that support the face diminish or shift downward (especially in the cheeks and temples) many patients notice drooping skin and excess tissue in the face and neck.
- Gravity: Over time, the natural pull of gravity typically exacerbates sagging — especially along the jawline.
- Sun damage: Unprotected sun exposure can not only affect the texture of the skin and compromise your complexion, it also accelerates the breakdown of collagen and skin thinning.
- Genetics: Some individuals are more prone to jowling and skin laxity simply based on genetic predisposition. This is due to inherited facial structure and skin quality.
Treatments to Resolve and Improve Skin Laxity
The right solution to address jowls and/or sagging skin depends on the severity of the skin laxity observed, your age, your health, and each patient’s personal goals. In general, surgical procedures like a facelift and neck lift can offer long-term, sophisticated rejuvenation while treatments like FaceTite® and Morpheus8® provide significant improvement without surgery and requiring little to no downtime, if any. A personalized consultation is the best way to determine which option (or combination of treatments) will help you enjoy a more refreshed, vibrant look.
The most ideal treatment for you often depends on where sagging skin is observed in the face:
- Jawline/Lower Face: A facelift and neck lift is considered the gold standard for treating moderate to severe jowling and sagging in the lower face and neck. The procedure repositions deeper facial tissues, tightens underlying muscles, and removes excess skin to restore a youthful, lifted appearance. Not only can a facelift and neck lift redefine the jawline and lower face, but it can be combined with other procedures for more comprehensive rejuvenation.
- Forehead/Brow: Those with a drooping brow or deep forehead lines can benefit from a brow lift, which is performed to reposition the forehead and eyebrows to a more rejuvenated positioning. The brow can become heavy and descend over time, contributing to a tired or stern look. A brow lift can be highly effective in restoring facial balance and facilitating a more refreshed, carefree expression.
- Upper and Lower Eyelids: Sagging or puffy eyelids often accompany the development of jowls and can be addressed with blepharoplasty. Known as upper and lower eyelid surgery, blepharoplasty targets excess skin and fat around the eyelids to restore a smooth, seamless contour.
- Face/Neck/Jawline: For patients with mild to moderate sagging who are not ready for surgery but still want noticeable improvement, non-surgical treatments like FaceTite® and Morpheus8® can provide excellent results. FaceTite® is a revolutionary treatment that uses radiofrequency-assisted lipolysis (RFAL) to tighten skin in the lower face and neck without surgery. This works by gently melting fat and stimulating collagen production, significantly improving early jowls and mild to moderate skin laxity. On the other hand, Morpheus8® is a non-surgical treatment that combines microneedling with radiofrequency energy to stimulate collagen, tighten skin, and improve texture. This in-office treatment can often be used to refine results after FaceTite®, or as a standalone treatment for mild sagging.
If you’re concerned about sagging skin or jowls, there are solutions to help you look as great as you feel. Dr. Ira Savetsky offers a full spectrum of facial rejuvenation procedures to help you look more refreshed, natural, and confident. Contact Dr. Savetsky today for more information or to book a consultation.