Facelifts and Jowls: A Targeted Approach to Lower Face Ageing 

Jowling — the descent of soft tissue along the jawline — is one of the most visible and commonly cited concerns in facial ageing. It blurs the crisp contour between the face and neck, softens jawline definition, and contributes to a heavier, more tired appearance. 

Although non-surgical treatments can soften or delay the first signs of ageing, only a well-performed facelift truly redefines the lower face and delivers lasting improvement in jowls and facial contour.

What Causes Jowls? 

Jowls form as part of the natural ageing process due to several interrelated anatomical changes: 

• Descent of the SMAS (superficial musculoaponeurotic system) — the deep connective tissue layer responsible for facial structure 

• Laxity of retaining ligaments that support the lower face 

• Loss of midface volume, which allows the cheek to descend and create heaviness below 

• Thinning and laxity of the skin 

• Accumulation of fat and soft tissue along the jawline 

These changes are progressive and influenced by genetics, skeletal structure, weight fluctuations, and environmental factors such as sun exposure and smoking. 

Why Non-Surgical Treatments Fall Short 

Injectables and thread lifts are often promoted as solutions for jowls, but their ability to produce meaningful correction is limited — particularly in patients with moderate to advanced tissue descent. 

• Dermal fillers can provide subtle camouflage in early stages, but excessive use risks further heaviness and distortion of natural proportions. 

• Thread lifting offers temporary elevation but does not reposition the underlying SMAS layer and typically lasts only 6–12 months. 

• Skin tightening devices (e.g. ultrasound or radiofrequency-based) may offer marginal improvement in skin tone but cannot reposition deep tissues. 

For patients seeking structural correction and long-term improvement, these modalities are insufficient. 

The Role of Facelift Surgery in Treating Jowls 

A facelift, when properly performed, addresses the root anatomical causes of jowling by lifting and securing the deep facial structures, rather than simply tightening the skin. 

Key surgical elements include: 

• Repositioning the SMAS layer to lift descended tissue and reestablish the jawline 

• Reinforcing ligamentous support to prevent recurrent sagging 

• Contouring redundant soft tissue and fat, particularly along the mandibular border 

• Redraping the skin without tension, ensuring a natural, unoperated appearance 

In some cases, a facelift is complemented by a neck lift, fat grafting, or chin augmentation to improve facial balance and optimise the cervicomental angle. 

This multi-layered approach produces results that are both natural in appearance and structurally durable. 

Who Is an Appropriate Candidate? 

Candidates for facelift surgery to address jowls typically present with: 

• Visible tissue descent in the lower face 

• Loss of jawline definition 

• Skin laxity or soft tissue redundancy 

• Stable health and realistic expectations 

Chronological age is less important than anatomical changes. Patients in their 40s with early jowling may benefit from a conservative lift, while those in their 50s and 60s often require more comprehensive correction. 

Longevity and Maintenance 

A facelift provides long-lasting improvement, typically in the range of 10–15 years, depending on skin quality, lifestyle, and ageing patterns. While ageing continues, the repositioned tissues maintain a more youthful structure. Patients consistently report looking better than their age over time. 

Subtle maintenance with non-surgical treatments may be used in the years following surgery, but the foundation of rejuvenation lies in deep structural repositioning. 

In Summary 

Jowling is a hallmark of facial ageing that reflects deep structural descent — not just surface skin laxity. While non-surgical interventions have a limited role in early or preventive care. Surgical correction remains the gold standard for restoring definition and balance to the lower face. 

A facelift, when executed with anatomical precision, restores the jawline, refines facial proportions, and achieves results that are both natural and enduring. 

At Jonathan Dunne Plastic Surgery, each facelift is carefully tailored to the individual. Guided by a detailed understanding of facial anatomy, ageing patterns, and patient goals. 

To find out if a facelift is right for you, book a consultation with Mr Jonathan Dunne, Consultant Plastic Surgeon. Call us on 020 8152 4700 or use the booking link on the homepage.