
Your Skin’s
Microbiome:
An Invisible Ally
Your Skin’s
Microbiome:
An Invisible Ally
Microbiome has become a buzzword in the world of skincare. Let’s take a deeper dive.
Jowls
Jowls and jowling is losing definition around our jawlines, and is a common issue as we age. In this month’s journal, I look at the causes and treatment options for targeting jowls.

Let’s start by understanding what causes jowls
As we get older, our skin becomes thinner and loses its elasticity in part due to lower levels of elastin and collagen. These two proteins are closely linked and work together, with collagen providing rigidity and strength and elastin allowing the skin to be flexible and bounce back to its original shape.
We lose volume in our cheeks and temples causing our chin and neck to become less defined. The long-term effects of gravity lead to the descent of facial tissues. Our skin also tends to become drier with age, making it less resilient and more vulnerable to the effects of gravity.
A gradual loss of bone shrinks the structural foundation upon which muscle, fat and skin rest, contributing to overall laxity. This loss of scaffolding can cause sagging skin to develop around the chin and jawline, creating heaviness in the lower face.
Jowls: lifestyle and genetic factors
Like many physical attributes, genetics plays a large role in how we age and the development of jowls.
Over-exposure to UV rays leads to cellular damage within the skin. This photodamage can accelerate the breakdown of collagen and elastin leading to increased signs of ageing including fine lines, wrinkles and jowls.
Smokers have lower rates of collagen production than non-smokers. Nicotine constricts blood vessels, robbing the skin of the vitamins and oxygen necessary to maintain healthy-looking skin.
But there is good news…a combination of preventative methods and treatment options can help keep jowls at bay.
Reducing the appearance of jowls
A healthy diet, not smoking and keeping fit and active all contribute to looking and feeling good. A good skincare regime is important to maintain skin health. Daily sunscreen will help prevent photodamage. Look for products with active ingredients such as vitamin C, niacinamide, retinol and peptides to help maintain skin elasticity.
There are several in-clinic treatments available to reduce the appearance of jowls. It is important to have a detailed consultation with a dermatologist or aesthetic practitioner to help plan a course of treatment, often a combination approach yields the best results.
Neurotoxins can be injected at strategic points depending on facial anatomy. This treatment is often used in conjunction with fillers to contour the overall look of the jawline. Precise and refined placement of neurotoxin works to harmonise your face and neck. Neurotoxin treatments can be customised to soften dynamic wrinkles and create a gently lifting effect.
Ultherapy® is a non-invasive treatment that delivers micro-focused ultrasound to create a thermal effect under the skin at precise depths. This in turn stimulates the body’s natural collagen production resulting in a gradual tightening and lifting effect, and improvement in the appearance of fine lines and wrinkles. Treated areas may include the brow, lower face, neck and décolletage. Ultherapy® is often chosen as an alternative to face or neck lift surgery and may also be used to maintain post-surgical results.
Radiesse is an FDA-approved filler composed of calcium hydroxylapatite. Hyperdilute Radiesse can treat skin laxity, especially over the neck. When diluted, Radiesse works as a powerful biostimulator, inducing the production of new collagen and elastin. Skin quality, texture and tone are improved naturally and gradually over time.
Hyaluronic acid fillers can be used to improve volume loss, refine contours and enhance facial features. Meticulous product selection and placement can gently lift the jawline, reducing the appearance of jowls.
Morpheus8 combines micro-needling and directional radio frequency. This FDA-approved device can help remodel subcutaneous tissue and fat while also improving skin texture, fine lines and wrinkles. It delivers powerful facial tightening, lifting and contouring.
Don’t ignore your jowls if they are affecting how you feel about yourself. Speak to a dermatologist about developing a treatment plan tailored specifically to your needs.
Dr. Alexis Granite is a world-renowned expert in medical and aesthetic dermatology. Certified in the US and the UK, she is a member of the American Academy of Dermatology (AAD) and the British Association of Dermatologists (BAD) and serves on the advisory board of the British Beauty Council.

Dr. Alexis is also the founder of Joonbyrd, a skincare and wellness brand that unites her mission to help patients feel confident in their own skin, with her grandmother’s legacy of finding JOY and meaning in self-care. She believes that when it comes to aesthetics, less is more. She brings a subtle artistry to her work so that you can look and feel incredible, every day.