I'm in my late 40s and have developed some jowling. Is there any help for a sagging jawline that's not a facelift?

I'm in my late 40s and at what I think is the tail end of perimenopause. I've noticed lots of changes in my face in the past six months, a lot of which I imagine are hormonal. One thing that's really bothering me is that it seems like I'm starting to lose definition in my lower face and have even developed a bit of jowling, which I do not love. Is there any help for a sagging jawline that's not a facelift? I don't want to go down that road, at least not yet. Thanks!
Dear Saggy in Seattle, A few years ago, I saw a popular beauty blogger in her early 30s advising a woman in her 60s about this very topic. The young woman, who, it should be said, had nary a wrinkle on her still-dewy visage, told the older advice seeker that she shouldn't treat a sagging jawline as a problem, but instead she should learn to LOVE her jowls! "Dance around with them! Enjoy them!" said the jowls-free blogger. I am not in the business of confronting strangers on the internet, but it's fair to say I was tempted to tell this young scribe to kindly f*** off.
I understand and appreciate the pro-aging sentiment. But at 52, I have a keen understanding of the challenge of having an aging face in a society that worships youth above all else. Put another way: There are many things I enjoy about getting older, but a melting face (chin/jaw/neck) is not one of them.
"The loss of crisp jawline definition as we mature is multifactorial in nature," dermatologist Dr. Ava Shamban tells me. "When we're born, our skin is practically spring loaded with collagen and elastin — two essential structural proteins that work together to keep skin firm, supple and resilient — but even as early as our late 20s, we naturally start to lose collagen, elastin and fat in the mid-face, meaning less structural support to hold things in place."
Shamban explains that this part of the face ages differently because it depends on the structure and shape of the mandible and the jawbone, which are, of course, unique to our specific anatomy.
"As we age, we have bone loss in the face, both of the mid-face and of the jawbone," explains Shamban. "As it shrinks or loses density, it changes the shape of the lower face and its integral support structure. In addition, the chin can recess, which contributes to excess drooping of the skin and tissue around the jawline. Finally, the skin in this area also loosens and so we have the resulting jowling, often accompanied by a sling of loose skin hanging under the chin, otherwise known as the turkey neck."
Sounds fun, right?
The good news, Shamban says, is if you want to address this inevitable phenomenon, you don't have to go under the knife — at least not at first.
"We have multiple science-backed ways to address this. You're not necessarily stuck with a sagging jawline and you don't have to jump immediately to a surgical procedure," she says.
Depending on your anatomy and where you are in the aging process, treatments include regular use of prescription-strength retinoids like Tretinoin and at-home red-light-therapy tools to build collagen and elastin, injectable dermal fillers in the mid-face and jawline to help augment the volume and bone loss and, perhaps most promising, tissue tightening and collagen building with non-invasive in-office ultrasound devices like Sofwave.
"One of the most effective nonsurgical options for jawline is Sofwave — it's an FDA-cleared treatment that uses advanced ultrasound to stimulate new collagen and elastin production," says Shamban. "It requires no downtime, needles or surgery and takes about 30-45 minutes per treatment. Most patients will require several treatments and see an ongoing improvement over about 12 weeks."
So, yes, there are non-surgical ways to address your sagging jawline, Saggy in Seattle, though it's important to note that these options can be pricey (for example, an average Sofwave session costs between $1,500 and $4,000). Your best bet is to book a consultation with a skilled, experienced dermatologist like Shamban, who can assess your bone structure and skin laxity and come up with the best treatment plan for you. On the upside, depending on the structure of your individual face, Shamban says a combination of these protocols can actually semi-reverse and push back the drooping point for years.
"There are so many challenging things that happen to your face as time goes by," Shamban tells me. "If the amount of wisdom that we acquire can be matched by a youthful, natural-looking appearance, it's a win-win — and that's the goal!"

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