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Dr Rory Dower

Home»Blog » How to treat a sagging jawline

How to treat a sagging jawline

It’s fairly common for women to come into my office and say “I just want this”, while putting their hands on either side of their lower cheeks and pulling them back to lift their drooping skin.

When we’re young, our chin and jawline form a smooth heart shape, which plastic surgeons refer to as the “upside down” triangle of youth. As we age, the shape of our face tends to look more like a triangle the right way up! The reasons for this are gravity, a loss of volume and stretching of the ligaments in your face.

So if you’re looking to lift the lower part of your face and smoothen your jawline, what options are available to you? Here’s my take on it:


1. Fillers

Fillers can help treat jowls, when they’re injected by needle or canula into three main areas:

• the cheeks: this restores volume in the cheeks and lifts the subcutaneous tissue which has a subtle effect on the lower face
• the pre-jowls sulcus (the dent in the jawline). This camouflages the jowls by smoothing the contour of your jaw.
• The jawline itself to help support the skin and soft tissue that is sagging

Good candidates are people with mild to moderate jowls, who are usually between 30 to 50 years old. They should also have good skin quality and elasticity.

• It’s quick and can be done in doctors’ rooms
• No anesthesia is required, so there is lower risk overall

• The results last around 12-18 months
• Not all cases of moderate jowling will be adequately treated
• This treatment is not able to treat severe jowling

Downtime: there is the possibility of swelling and bruising for 2-3 days, but no significant downtime

Cost: From R3 700 – R20 000

2. Facial threads

Threads with barbs are inserted and “threaded” under the skin to the nasolabial fold or jowl area, in order to lift the subcutaneous tissue. They remain there and have a tightening effect, as well as stimulating the production of collagen.

Good candidates are those with mild to moderate jowls, with good skin quality and elasticity.

• It’s safe
• Performed with local anesthetic at the insertion point
• The treatment is quick

• Results last around 18-24 months

Downtime: Minimal downtime, although there can be bruising and swelling for 3-5 days. A flesh colored plaster supports the threads for 2 days.

Cost: From R8 000 – R24 000


1. Face lift

A surgical procedure like this gets to the root of the issue, instead of working from the outside. This is because under our skin and overlying the bone lies the SMAS (superficial musculo-aponeurotic system). This is quite literally, the supportive structure of the face and acts as a 3D scaffolding for your overlying skin.

During a facelift procedure, we lift and stitch this SMAS to its former, more youthful position and re-drape the skin naturally over the new, more chiseled contours of your face. Importantly, the skin is sutured without tension and because of this, along with the discreet position, scars have a smoother healing process and with time, appear seamless.

This is my preferred technique of facelift, as it addresses many of the components of facial aging, not only around the lower face (jowls, jawline, and neck) but also the mid-face (cheeks and nasolabial folds).

Ideal candidates for this procedure are:

• Over 40 years old
• Preferably non-smokers
• Those who have moderate to severe jowls
• People who haven’t been satisfied with previous non-invasive treatments
• Those who want something more powerful and long lasting


• When done well, the result is natural, elegant and powerful
• You can expect a facelift to make you look at least 10 years younger
• It’s long lasting: although your face continues to age, you will still look younger in 10 years than your contemporaries who’ve never had surgery

• The most invasive procedure
• The most expensive
• The longest downtime
• Requires General Anesthetic, which carries with it associated risks


• You can expect a fair amount of swelling and bruising for the first 2 – 3 weeks
• After 4 weeks you’ll look better than you did before the surgery, and you can plan to make an appearance at a big event or special occasion roughly 6 weeks after your surgery.

Cost: From R80 000

To sum up, I advise patients with mild jowls to choose non-surgical techniques like filler or threads, as these can offer them the results they’re looking for. Patients with moderate jowls will see some improvements, but may not get full correction or be fully satisfied.

Patients with severe jowls will usually need surgical correction. If you’re against surgery, you can benefit from non-surgical techniques, but you may not be fully happy with the results.

Our philosophy at Therapy Specialist Medical Spa, is to work as a team, starting with effective skin care and using non-invasive techniques where possible…if a time comes when we know we aren’t able to achieve what we’re hoping to with these techniques, we speak openly with our patients, because we don’t want to create an overdone look. At this time, our patients either make peace with where they are and keep their skin healthy and glowing to soften wrinkles, or opt for a surgical technique.

Remember, ageing beautifully is always a multi-faceted approach. Actively treating your skin from an early age and keeping fit and healthy, can in itself be enough to prevent or delay your desire or need for surgery.

If you’re interested in learning more, get in touch with us

This was featured in our March 2019 Therapy Specialist Medical Spa Newsletter