Blog Kerolus Facial Plastic Surgery

A Modern Guide to Jowls

It’s rarely a Freaky Friday moment when you wake up and slap your hands on your face and say “I’m old!” Usually, you’re looking down at your phone and catch your reflection in the black screen, or you’re trying on a new pair of statement earrings and realize the sharp, clean line that used to frame them has softened. It’s that subtle "heaviness" at the corners of the mouth that makes you look tired or stern, even when you’ve had eight hours of sleep and a double espresso.

When patients visit my Gold Coast Atlanta office, they almost always do the same thing: they use their index fingers to pull the skin back toward their ears and say, "I just want it to stay right here."

What We’re Talking About 

Jowls are the pockets of soft tissue that settle along the jawline as the mid-face loses its structural support. This occurs when the collagen bonds weaken and the facial fat pads migrate downward, causing the once-sharp boundary between the face and neck to soften into visible folds.

The Architecture of the Slide

Creams and lotions are fine for surface texture, but they won't fix jowls. This is a structural issue. Your face is like a house when the foundation is settling. As the years pass, the jawbone slightly recedes and the fat pads in your cheeks descend. Putting a firming lotion on your jawline is like putting new wallpaper on a house with a sinking foundation. To see real change, we have to address the layers underneath.

In my practice, I focus on facial harmony. I’m not interested in making you look like a different person or someone who’s been caught in a wind tunnel. I want to put the anatomy back where it belongs. Whether that’s through strategic, deep-plane lifting or very intentional, conservative contouring, the goal is always the same: a jawline that looks like it belongs to you, not a surgeon.

Jowl Treatments At A Glance 

The Filler Trap

Filler is a useful tool, but it is a poor substitute for a facelift. In many clinics, the standard response to jowls is to pump filler into the jawline to hide the sag. This works for a slight shadow, but there is a limit. Adding volume to a lower face that already feels heavy often results in a wide or overstuffed look. We want a refined profile, not a wider one. I prefer to lift and reposition. When we move the tissue back to the cheek, we rarely need much filler at all.

The "Ozempic" Factor

We also can't talk about jawlines in 2026 without mentioning the impact of rapid weight loss. It could be lifestyle changes or GLP-1 medications, but losing weight quickly leaves the skin "deflated." If the volume leaves but the skin remains, the jowls can seem to appear almost overnight. If this is your situation, know that you haven't done anything "wrong"—your skin just needs a little help catching up to your new, healthier body.

Why I Go Deeper 

"Deep Plane" is a buzzword now, but for me, it is a surgical necessity. Traditional lifts involved pulling the skin tight and trimming the excess. That is how people end up looking distorted.

I go beneath the muscle layer to release the stubborn ligaments that hold your face in a downward position. Once those are released, I can glide the skin, fat, and muscle back up as one unit. Since the foundation moves with the skin, there is no tension. You look like a refreshed version of yourself, not a "pulled" version.

Restoration, Not Tension

The Deep Plane Facelift is different because it doesn't rely on pulling your skin. Instead, I go beneath the muscle layer (the SMAS) to release the tiny, stubborn ligaments that are tethering your face in a downward position.

Once those tethers are released, the entire unit—the skin, the fat pads, and the muscle—can be gently glided back up to where it sat ten or fifteen years ago. Because we are moving the foundation and the wallpaper at the same time, there’s no tension on the skin. You don’t look "pulled"; you just look like a refreshed version of the person you see in your graduation photos.

The "Hidden" Benefits

One of my favorite things about the deep plane approach is what it does for the mid-face. A standard facelift often ignores the area around the nose and mouth. But by working in the deep plane, I can naturally restore volume to your cheeks and soften those deep "parentheses" lines (nasolabial folds) without ever touching a syringe of filler.

The "Radical Honesty" Notebook

I promise my patients three things: clinical excellence, natural results, and no fluff. So, let’s talk about the parts of this process that aren't usually in the brochure.

1. Recovery isn't a "pain" thing; it's a "patience" thing. 

"How much will it hurt?" Truthfully? Most of my patients stop taking anything stronger than Tylenol after day two. But you will feel tight. It’s a strange, heavy sensation, like your face is wearing a very snug turtleneck. You’ll have about 10 to 14 days of "social downtime" where you’ll want to stay in, binge-watch your favorite show, and let the swelling do its thing.

2. I might tell you "not yet." 

I turn away patients every month who ask for a facelift but aren't ready for one. If your jawline "softness" is purely a matter of skin texture, we’ll start with Morpheus8 or medical-grade skincare. I only recommend surgery when the structural descent has reached a point where non-surgical tools wouldn't achieve your desired outcome.

3. The smoking conversation. 

This is my one non-negotiable. If you smoke or use nicotine, your skin cannot heal properly. Period. We want those incisions to disappear into your natural hairline, and nicotine prevents the blood flow necessary for that "invisible" healing. We’ll need you to be nicotine-free for at least twelve weeks before and after.

Section V: The Questions You’re Actually Asking

When you spend enough time in consultation rooms, you realize that Google and real life don't always align. Here is the "insider" take on the myths and nuances I discuss with my patients every day.

The FAQs:

"Is 'Zoom Face' real?" 

Yes. Constantly looking down at a laptop exaggerates jowls that might not be visible if you were looking straight ahead.

"Can face yoga or jawline exercises help?" 

I wish I could tell you yes, but the truth is that jowls aren't caused by weak muscles. They’re caused by skin laxity and fat migration. In fact, repetitive "jaw exercises" can actually worsen the lines around your mouth (marionette lines) by constantly creasing the skin. Think of it like bending a piece of plastic, the more you bend it, the more permanent the crease becomes.

"Does sleeping on my side make one jowl worse than the other?" 

You might have noticed that one side of your face feels a little "heavier" than the other. We call this facial asymmetry, and yes, your sleep position plays a role. Spending eight hours a night with 11 pounds of head weight pressing your cheek into a pillow can definitely accelerate the breakdown of collagen on that side. While I always suggest trying to sleep on your back (and perhaps investing in a silk pillowcase), don't lose sleep over it. We can easily account for that asymmetry during treatment.

"What is that little 'dip' next to my chin?" 

That is the pre-jowl sulcus. Sometimes a jowl looks huge only because the hollow next to it is deep. Softening that specific dip with a small amount of filler or fat can occasionally fix the whole profile.

Reclaiming Your Profile

A softening jawline is just a side effect of a life well-lived. Refining it isn't about chasing a version of yourself that doesn't exist. It is about looking in the mirror and seeing the same clarity you feel on the inside. You are beautiful in every phase of your life. My job is to make sure you move through the world feeling like the best version of the phase you’re in right now