LiftingJowls: Effective Lifting Methods by a Board-Certified Plastic Surgeon

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Hello and welcome! ๐Ÿ˜Š

I’m Dr. Seung Wan Tak, a board-certified plastic surgeon based in Gangnam, Seoul. At Dr. Tak Plastic Surgery, I specialize in improving sagging jowls through advanced lifting techniques tailored to your unique needs.

In Korea, sagging jowls are sometimes referred to as "bulldog jowls" due to their resemblance to a bulldog’s drooping cheeks. Regardless of what we call them, sagging jowls are a common concern that can make the face appear older and heavier.


Understanding Sagging Jowls

As we age, the natural elasticity of the skin reduces, leading to noticeable changes in the face. One of the most dramatic transformations occurs in the jowl area, where sagging skin around the cheeks and jawline can add years to your appearance.Close-up of an older woman's sagging jowls, highlighting the effects of aging on the cheeks and jawline with yellow arrows pointing to the affected areas.

What many people don’t know is that there are four distinct types of sagging jowls, and each requires a tailored approach to achieve the best results. Today, we’ll explore each type and their corresponding treatments in detail, keeping medical jargon to a minimum for easy understanding.


Type 1: Skin-Type Jowls

Skin-type jowls occur when the skin sags due to reduced elasticity in the SMAS (Superficial Musculoaponeurotic System) layer, which acts as a supporting structure for facial skin.Illustration of skin layers showing the SMAS (Superficial Musculoaponeurotic System) layer beneath the skin, fat, and muscle, highlighting the role of SMAS in supporting facial skin.

Treatment Options

For mild sagging:

  • Laser Lifting Treatments
    Technologies like Ultherapy (Ulthera), Thermage, or Shurink apply heat energy to tighten the SMAS layer, helping to lift sagging skin. Think of it as applying heat to shrink a piece of meat—it tightens naturally.

Diagram showcasing laser lifting treatments such as Ultherapy, Thermage, and Shurink, illustrating how heat energy targets different skin depths to tighten the SMAS layer and lift sagging skin.

For moderate to severe sagging:

  • Thread Lifting
    Thin, hook-shaped threads are inserted to pull the skin upward, offering a non-invasive yet effective solution.

  • Facelift Surgery
    In advanced cases, excess skin is excised, and the SMAS layer is lifted and sutured for a more dramatic and lasting result.

๐Ÿ’ก Pro Tip: Younger patients often benefit from thread lifting, while older individuals with more significant sagging may achieve better results with a surgical facelift.


Type 2: Deep Fat-Type Jowls

Deep fat-type jowls stem from the buccal fat pads, soft fat deposits that extend from the temples to the lips. These fat pads are genetic, meaning their size is determined at birth and unaffected by weight gain or loss.

Characteristics of Deep Fat-Type Jowls

  • Prominent bulging near the mouth corners when lips are closed.
  • Can occur even in younger patients if buccal fat pads are naturally large or heavy.

Treatment Options

  • Buccal Fat Pad Removal Surgery
    A minimally invasive procedure performed through incisions inside the mouth, leaving no visible scars. It effectively reduces the weight of the buccal fat pads, preventing further sagging.

Profile view showcasing sagging jowls due to buccal fat pads, illustrating the target area for surgical removal to improve facial contour.A minimally invasive buccal fat pad removal surgery being performed by Dr. Tak to address sagging jowls caused by deep fat deposits, ensuring no visible scars.

  • Targeted Fat Reduction
    Although fat-dissolving injections can be attempted, they are often less effective for this type, making surgery the preferred option.

Note: Removing just the protruding portion of the buccal fat pad ensures the cheeks retain a natural appearance, avoiding a hollowed-out look. Trust a specialist to determine the precise amount to remove.


Type 3: Subcutaneous Fat-Type Jowls

This type of jowl is caused by excessive subcutaneous fat, or fat just beneath the skin, which accumulates over time and leads to sagging.

Diagram highlighting the subcutaneous fat layer beneath the skin, demonstrating how excess fat accumulation in this layer contributes to sagging jowls over time.

What Causes Subcutaneous Fat-Type Jowls?

  • Some people naturally have thicker subcutaneous fat in the face, despite being slim overall.
  • Others experience sudden weight gain during hormonal changes, such as menopause, causing the face to appear rounder and fuller.

This added weight in the face eventually overwhelms the skin's support structure, leading to sagging jowls.

Treatment Options

  1. Fat Dissolving Injections or Liposuction
    • While commonly recommended, I caution against relying solely on these treatments. Facial fat removal alone isn’t always effective unless combined with sustained weight management.
      Doctor holding a syringe, symbolizing fat-dissolving injections or liposuction as treatments for facial fat reduction, often recommended alongside sustained weight management for effective results. 
  2. Diet and Weight Loss
    • Subcutaneous fat is best addressed through a combination of professional treatments and lifestyle changes.
    • I always emphasize the importance of maintaining a healthy weight before considering treatments for long-term results.

๐Ÿ’ก Pro Tip: Start with diet adjustments to reduce facial fat naturally. Once you’ve minimized excess fat, additional treatments like liposuction can be considered for enhanced results.


Type 4: Small-Chin-Type Jowls

The last type of jowl is caused by having a recessed or small chin, which fails to provide adequate support to the overlying facial tissue. This type of jowl is often referred to as "small-chin-type jowls."

Why Does a Small Chin Cause Jowls?

  • A small chin lacks the structural support to hold cheek fat in place, causing it to sag downward.
  • From a proportional perspective, the recessed chin makes sagging jowls appear more prominent, giving the face a heavier or “droopy” look.

Treatment Options

  1. Chin Augmentation Surgery
    • A silicone implant can be placed to provide a stronger chin structure, effectively lifting and reducing the appearance of jowls.Before and after photos showing the results of chin augmentation and filler treatments, highlighting improved chin projection and reduced jowls for a more balanced facial profile.
  2. Chin Fillers
    • For those hesitant about implants, fillers are a non-invasive option to improve chin projection and balance facial proportions.

๐Ÿ’ก Pro Tip: Enhancing the chin not only minimizes sagging jowls but also improves overall facial harmony. Patients with this type often report the most dramatic before-and-after transformations.


Wrapping Up

In this two-part series, I’ve broken down the four types of sagging jowls and their respective treatments:

  1. Skin-Type Jowls
  2. Deep Fat-Type Jowls
  3. Subcutaneous Fat-Type Jowls
  4. Small-Chin-Type Jowls

Each type requires a tailored approach, and understanding the underlying cause is the first step toward achieving effective and lasting results.

If you’re unsure about your jowl type or want to explore treatment options, I invite you to schedule a personalized consultation with me.


What's Next?

If you have questions about jowl correction or want to explore your options, feel free to leave a comment or contact us directly via Instagram.

Thank you for reading! ๐Ÿ˜Š

  • Dr. Seung Wan Tak, Chief Director of Dr. Tak Plastic Surgery

Reception area at Dr. Tak Plastic Surgery Clinic in Seoul, featuring a modern and welcoming design.Entrance of Dr. Tak Plastic Surgery Clinic, highlighting the clinic's logo and elegant wooden design.

๐Ÿ“Visit Us
Dr. Tak Plastic Surgery Clinic
9th Floor, 423 Gangnam-daero, Seocho-gu, Seoul
๐Ÿ“ž 02-534-1234


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