Three ways your lower face may be ageing you: All things jowls, marionette lines and nasolabial folds
18 March 2024
By Dr Sophie Shotter

Lower Face Ageing, West Malling, Kent
As we age, our skin naturally loses elasticity, collagen production decreases, and the distribution of facial fat changes. These processes can significantly affect the lower face, leading to features that may make us appear older than we feel. Three common signs of ageing in the lower face that prompt many men and women to come and see me include jowls, marionette lines, and nasolabial folds. Let’s delve into what these are, why they occur, and explore strategic treatments to reverse these changes.
The problem: Jowls
What Happens:
Jowls are the sagging skin and fat below the chin or jawline that become more pronounced with age. This sagging is primarily due to the loss of elasticity in the skin, a descent of facial fat, and the weakening of facial muscles over time. As a result, the skin begins to droop, creating a heavier appearance around the lower face and jawline.
Reversing Jowls: The options
Sofwave
Sofwave represents the forefront of ultrasound-based treatments, uniquely targeting the skin’s mid-dermal layer. By heating this targeted area, the treatment harnesses the body’s own collagen production mechanisms. This stimulation results in a subtle yet significant tightening and lifting effect on the skin, effectively diminishing the appearance of jowls. What sets Sofwave apart is its relative comfort during treatment, the lack of any required downtime, and its suitability for all skin types. As the skin undergoes a process of renewal and strengthening from within, the results gradually emerge, showing a firmer, more youthful complexion.
HArmonyCa
HArmonyCa is an innovative treatment that combines two key components: calcium hydroxyapatite (CaHA) and hyaluronic acid (HA). CaHA provides a scaffolding effect, supporting the skin’s structure, while HA offers immediate hydration and volume enhancement. This combination not only restores volume loss in the cheeks and jawline, effectively lifting the jowls, but also promotes long-term collagen production, enhancing skin quality and firmness over time. HArmonyCa is an excellent choice for those seeking both immediate and lasting improvement in jowl appearance.
Profound RF
Profound RF stands out as a non-invasive treatment that combines microneedling and radiofrequency energy to target the deeper layers of the skin. The device delivers controlled heat to the skin, which not only tightens existing collagen fibres but also stimulates the production of new collagen, elastin, and hyaluronic acid. This treatment is particularly effective in improving skin elasticity and firmness, leading to a noticeable reduction in the appearance of jowls. The process typically involves a single session, and results can be seen over a period of weeks to months as the skin naturally regenerates and rejuvenates.
The problem: Marionette Lines
What Happens:
Marionette lines run from the corners of the mouth down to the chin, resembling a puppet’s mouth. These lines deepen with age as skin elasticity decreases and volume loss occurs around the mouth and chin.
Reversing Marionette Lines: The options
Dermal fillers
We can use fillers to address the changes in mid and lower face volume which cause marionette lines to form – cheeks, chin and jawline for example. Injectable fillers can also add volume directly to the marionette lines, plumping and smoothing the skin from within. This treatment can effectively diminish the appearance of these lines, restoring a more youthful contour to the mouth and chin area.
Botox
While traditionally known for relaxing dynamic wrinkles, Botox can also be carefully applied to relax the muscles contributing to the deepening of marionette lines. This approach can soften the appearance of the lines and prevent them from worsening.
The problem: Nasolabial Folds
What Happens:
The nose-to-mouth lines – the nasolabial lines, also referred to as ‘smile lines’ or ‘laughter lines’ – are among the biggest bugbears for most ageing faces. They appear as creases that develop at the side of your nostrils and extend down toward the corners of the mouth. As they become more prominent, it’s common for them to overhang and sag forwards towards the mouth.
Reversing Nasolabial Folds: The options
Dermal fillers
Restoring lost support in the cheek area can provide a subtle but effective lift to the entire midface, including the nasolabial folds. By replenishing volume in the cheeks, the skin is lifted upwards, reducing the depth and appearance of nasolabial folds. This approach not only addresses the folds themselves but enhances overall facial harmony by restoring youthful contours to the cheeks.
Tailoring the Treatment to You
While these treatments are effective, it’s crucial to consult with a skilled medical practitioner who can recommend a personalised treatment plan based on your unique facial structure and ageing concerns. In some case, it may even be beneficial to combine different treatments to achieve a more natural and harmonious result.
Ageing is a natural process, and whilst we can’t stop it, we can certainly manage its visible signs with the right strategies. By understanding the specific ways in which our lower face ages, we can target these areas with precision treatments that rejuvenate and refresh our appearance, helping us feel as youthful on the outside as we do on the inside.
If you’d like to discuss the options and establish what’s right for you, click here to enquire or to book a consultation.
