What Is The Best Treatment For Jawline Definition?

Posted on October 14, 2026October 14, 2026 by Michelle Dodd

The best approach to jawline definition depends on the underlying cause. Four key anatomical factors influence the appearance of the jawline: muscle size and downward pull, facial fat distribution, skin laxity and the structure of the mandible (jawbone). The chin and surrounding facial features also affect the overall contour. A personalised assessment helps identify which factors are contributing to the concern and whether surgical and non-surgical treatment options may be appropriate. There is no single approach that suits everyone.

A well-defined jawline is something many people would like to achieve. During consultations, I often hear patients describe their concern as their cheek blending into their neck, or feeling that their jawline has lost the distinct angle and contour it once had.

But what actually determines jawline definition?

The answer is more complex than you might think.

After nearly 13 years working in aesthetic medicine, one of the most important things I have learnt is that two people can have very similar concerns about their jawline for completely different anatomical reasons.

For one person, muscle bulk of the masseter muscle may contribute to a wider lower face. For another, the appearance of the jawline may be influenced by subcutaneous fat, skin laxity, jowling or the underlying structure of the mandible. Often, several factors contribute at the same time.

There is no single best treatment for jawline definition. The most appropriate approach depends on understanding what is causing the concern in the first place.

In this article, I’ll explain the four main anatomical factors I assess when someone presents with concerns about their jawline, why the chin and surrounding facial structures also matter, and what you should understand before considering treatment.

What determines jawline definition?

Jawline definition is influenced by the relationship between the underlying bone, the muscles, the fat compartments and the skin and soft tissues covering them.

I assess four key anatomical factors:

Muscle — particularly the masseter and platysma.
Fat — including subcutaneous and submental fat.
Skin laxity — and the development of jowls.
The mandible — the bone that forms the lower jaw.

The chin, mid-face and overall facial proportions must also be considered because the jawline does not exist in isolation.

Let’s look at each factor in more detail.

1. Muscle: Can your jaw muscles change the shape of your face?

Two muscles are particularly relevant when assessing jawline definition: the masseter and the platysma.

The masseter muscle

The masseter is one of the main muscles responsible for chewing. It sits at the side of the jaw and helps elevate the mandible when you bite down.

Like other muscles, the masseter can increase in size through repeated use. This is known as muscle hypertrophy.

In some people, the masseter becomes more prominent in association with teeth clenching or bruxism (teeth grinding). In others, a naturally strong masseter contributes to their facial shape.

When the muscle becomes larger, it can create a wider, squarer appearance at the angle of the jaw.

Interestingly, this change can happen gradually over several years. Some patients only recognise it when comparing recent photographs with older ones, commenting that their face never used to look this shape.

During an assessment, I ask patients to bite down while I palpate the masseter muscles. This helps me evaluate their size, prominence and muscular contraction in the context of their overall facial anatomy.

It is important to understand that a wider lower face does not automatically mean that the masseter is enlarged. The underlying bone structure and surrounding soft tissue also influence facial width.

If you suspect that you grind or clench your teeth, it is worth discussing this with your dentist, particularly if you experience tooth wear, jaw discomfort or morning jaw fatigue.

To understand how the masseter muscle size influences facial width, read out article about masseter muscles and facial slimming.

The platysma muscle

The platysma is a broad, thin sheet-like muscle that extends across the neck and attaches into the lower face and jawline region.

Its function includes helping to depress the mandible and contributing to tension in the skin of the neck.

When the platysma contracts, its downward pull can influence the appearance of the lower face and neck. This is particularly noticeable in some people when they animate their facial muscles.

During a consultation, I ask patients to say “eeee” to help demonstrate platysma activity. I can then assess how the muscle contracts and how its movement relates to the surrounding tissues.

This is one reason I don’t assess jawline concerns solely by looking at a photograph or examining the face at rest. Muscle activity can provide additional information about what is contributing to the appearance of the jawline.

Learn more about platysma anatomy on our neck consultation page.

2. Subcutaneous fat: Is facial fullness hiding your jawline?

One of the most common misconceptions I encounter is that a person who cannot see a distinct jawline must have poor bone structure.

That isn’t necessarily the case.

The underlying jawbone may be well defined, but the soft tissue covering it can soften the visible contour.

Subcutaneous fat is the fat located beneath the skin. Its distribution varies naturally between individuals and can contribute to fullness across the cheeks, lower face and jawline.

There are several distinct concerns worth differentiating.

Submental fullness

The submental region is the area directly beneath the chin. Fullness here can soften the transition between the chin and neck, making the jawline less distinct.

Some people describe this as having a “double chin”.

However, the appearance of this area can also change with head position. Looking down naturally causes the chin and neck tissues to compress and fold. This alone does not establish that someone has excess fat or requires treatment.

Fullness along the jawline

Some people have naturally fuller tissue over the lower face, which can soften the angle between the jaw and neck.

The important question is whether the fullness is related to fat distribution, underlying bone structure, skin laxity or a combination of these factors.

These causes can look similar from the front but require different considerations when assessing the face.

Why natural fullness matters

I once assessed a patient who wanted a more defined jawline because she felt her face looked too full.

On examination, the fullness was a natural feature of her facial anatomy rather than an isolated problem that I felt needed correcting.

I explained that natural facial fullness contributes to the appearance of youthful skin and provides underlying soft-tissue support. As we age, facial fat distribution and volume change, and some areas can lose fullness over time.

In this case, I did not recommend treatment.

I think this is an important point, particularly for younger patients who compare their faces with highly sculpted images online. Natural fullness is not automatically something that needs to be removed or reduced.

My role is not to convince someone that every feature they dislike needs correcting. It is to assess their anatomy, explain what I see and help them make an informed decision.

3. Skin laxity: When the jawline begins to soften

Skin and soft-tissue changes can also influence jawline definition.

As we age, changes in skin elasticity, connective tissue, fat distribution and the supporting structures of the face can contribute to a softer lower-face contour.

One common concern is the development of jowls.

What causes jowls?

Jowls are the areas of tissue that become more prominent along the lower sides of the face, around the jawline and towards the chin.

Their development is multifactorial. Changes in skin elasticity, facial fat compartments and the supporting retaining ligaments all contribute to the changing contour of the lower face.

Jowls are different from fullness directly beneath the chin. Although both can make the jawline appear less defined, they are anatomically distinct concerns.

Skin laxity can also coexist with subcutaneous fullness. This is why simply identifying an area that looks fuller does not tell us what is causing it.

Why skin laxity and fullness must be distinguished

During an assessment, I examine the skin and underlying tissues, including their mobility and elasticity. I also consider how the lower face looks from different angles and how the skin sits over the underlying structures.

A concern primarily related to skin laxity is different from one primarily related to fullness beneath the skin.

Addressing one factor does not necessarily address the other.

For example, an approach intended to reduce fullness would not automatically correct skin laxity. Equally, an approach directed at skin laxity would not necessarily change the amount or distribution of underlying fat.

Some patients have a combination of concerns, which is why a personalised assessment may involve discussing different treatment modalities rather than assuming one approach will address everything.

4. The mandible: Your underlying jawbone structure

The mandible is the bone that forms your lower jaw. It provides structural support for the soft tissues above it and plays a major role in determining the shape and proportions of the lower face.

I often think of the mandible as the support beams of a house. The structures above it depend, in part, on the foundation beneath them.

The shape, width, angle and projection of the mandible vary considerably between individuals. These differences are a normal part of human anatomy.

Someone with a naturally prominent jaw angle may have a more defined contour than someone with a narrower or less prominent underlying structure, even if their soft tissues are otherwise similar.

Why the chin matters when assessing the jawline

The chin is particularly important when evaluating the jawline from the side.

I have seen patients present with the concern that they have no jawline definition in profile. On assessment, one patient had a receded or regressed chin, which contributed to the appearance that the jawline was effectively “cut off” at the front.

The concern was described as a jawline problem, but the chin was an important part of the explanation.

This is why I assess the relationship between the chin, mandible, lower face and neck rather than focusing on one isolated area.

Mid-face changes and skin laxity can also influence the overall facial proportions, so these may need to be considered as part of the broader assessment.

Not every concern related to bone structure can be addressed in the same way as a concern related to the soft tissues. During a consultation, I explain what the individual’s anatomy allows us to consider and establish realistic expectations about what may be achievable.

How I assess jawline definition during a consultation

When someone comes to see me about their jawline, I don’t start by deciding which treatment they need.

I start by assessing their anatomy.

My assessment includes examining the face from the front, at a 45-degree angle and in side profile. Each view provides different information about facial proportions, the jaw angle, chin projection and the transition between the face and neck.

I also assess several anatomical features:

Muscle activity: I palpate the masseters during clenching and observe platysma contraction.
Underlying bone: I assess the shape and prominence of the mandible and the position of the chin.
Soft-tissue fullness: I examine the distribution of subcutaneous fat and any fullness beneath the chin.
Skin and tissue support: I assess skin elasticity, tissue mobility and the presence of jowling.
Overall facial harmony: I consider how the jawline relates to the chin, cheeks, mid-face and upper face.

This process helps distinguish between concerns that may appear similar but have different underlying causes.

It also helps establish whether the desired outcome is realistic and whether any intervention is appropriate.

So, what is the best treatment for jawline definition?

The most appropriate approach depends on the anatomical factors contributing to the concern.

There is no universal treatment that suits everyone, and a treatment that may be appropriate for one person may not be suitable for another.

Broadly, management may involve discussing surgical or non-surgical treatment modalities, depending on the assessment, the individual’s goals and their suitability for the available options.

These decisions should be made during a personalised consultation with an appropriately qualified practitioner who can assess the relevant anatomy, explain the available options and discuss their limitations and risks.

It is equally important to recognise when treatment is unlikely to provide the result someone is seeking, or when no treatment is the most appropriate recommendation.

The goal should not be to force every face into the same jawline shape. It should be to understand the individual’s anatomy and determine what, if anything, is appropriate for them.

Why I don’t recommend chasing an exaggerated jawline

Social media has made highly angular jawlines increasingly visible. Before-and-after photographs can create the impression that everyone should have a sharp, straight line from the chin to the angle of the jaw.

But these images do not always tell the whole story.

Photographs can be influenced by lighting, head position, camera angles, editing and image selection. Images taken shortly after a procedure may also show temporary swelling, which should not be mistaken for a long-term result.

Anatomy matters, too.

Female faces often have softer jawline contours than male faces, although there is considerable natural variation within both groups. A very angular jawline may look harmonious on one person but disproportionate on another.

Imagine someone with a naturally soft, narrow upper and mid-face who wants a substantially wider, square lower face. If the desired change is out of proportion with their existing features, the result may not look as harmonious as they expected.

I have seen how patients can become focused on a particular feature or image without considering how it relates to their face as a whole.

This is why I believe facial assessment should consider the overall balance of the face rather than treating jawline definition as an isolated aesthetic goal.

A more angular jawline is not necessarily a better jawline. The aim should be a result that respects the individual’s natural anatomy and proportions.

The importance of realistic expectations

One of the most valuable parts of a consultation is discussing what can realistically be achieved.

Every person has different bone structure, muscle size, fat distribution and skin characteristics. These differences influence both the available options and their potential results.

It is also important to consider how the face changes over time. Natural facial fullness, tissue support and skin elasticity can change with age, and an approach that seems appealing at one stage of life may not be appropriate for another.

A thorough assessment allows these factors to be considered before any decision is made.

My approach is to explain the anatomy, discuss appropriate options and their limitations, and help patients understand what is realistic for them as an individual.

Sometimes, that means discussing treatment. Sometimes, it means explaining why a particular concern cannot be addressed in the way someone initially imagined. And sometimes, it means recommending no treatment at all.

Considering jawline treatment? Start with an assessment.

If your jawline blends into your neck, you have noticed changes in your lower face or you feel your facial contours have become less distinct, the first step is understanding why.

Muscle, fat, skin laxity and the underlying jawbone can all influence the appearance of the jawline. The chin and surrounding facial structures also play an important role.

A personalised consultation allows these factors to be assessed together, rather than assuming the visible concern tells the whole story.

My approach is grounded in anatomical assessment, patient education and realistic expectations. The aim is to help you understand your facial structure and make an informed decision about whether any intervention is appropriate.

To discuss your concerns, you can arrange a consultation at 3 locations across Sydney in Surry Hills, Mosman or Penrith.

Frequently Asked Questions

What is the best treatment for jawline definition?

There is no single best treatment for everyone. Jawline definition can be influenced by muscle size, subcutaneous fat, skin laxity, jowling and underlying bone structure. A personalised assessment helps identify the contributing factors and determine which options, if any, may be appropriate.

Why does my jawline blend into my neck?

A less distinct jaw-to-neck angle can be influenced by fullness beneath the chin, soft-tissue distribution, skin laxity, the position of the chin and the underlying jawbone. Head position can also change the appearance of this area. An assessment is needed to distinguish between these factors.

Can you improve jawline definition without surgery?

Depending on the cause of the concern, surgical and non-surgical approaches may be considered upon consultation. However, not every anatomical concern can be addressed effectively without surgery, and some may not be suitable for treatment. The appropriate options depend on your anatomy, goals and individual suitability.

How can I tell whether my jawline concern is caused by fat or loose skin?

Fat-related fullness and skin laxity can look similar, and both can occur together. An assessment considers the distribution of fullness, skin elasticity, tissue mobility and the underlying facial structure. The distinction matters because addressing one factor does not necessarily address the other.

Does teeth grinding cause a wider jaw?

Repeated clenching or grinding can contribute to enlargement of the masseter muscles in some people. Because these muscles sit at the sides of the jaw, increased muscle bulk can make the lower face appear wider or squarer. However, facial width is also influenced by natural muscle size, bone structure and soft-tissue distribution.

What causes jowls, and can they be treated without surgery?

Jowls develop through a combination of age-related changes in skin elasticity, facial fat distribution and the supporting tissues of the lower face. The most appropriate management depends on the degree of tissue laxity, the underlying anatomy and the individual’s goals. Non-surgical approaches have limitations, and a consultation can help clarify which options may be suitable.

Does having a weak or receded chin affect jawline definition?

Yes. A receded chin can alter the side-profile relationship between the chin, lower jaw and neck, making the jawline appear less distinct. This is why chin projection should be assessed alongside the jawline rather than assuming the concern originates solely from the jaw angle or soft tissues.

Why has my jawline changed as I’ve aged?

Age-related changes can affect boney support, skin elasticity, facial fat distribution, soft-tissue support and the appearance of the lower face. These changes occur at different rates in different people. Genetics, natural facial structure and muscle activity can also influence how the jawline changes over time.

Can everyone achieve a sharp, angular jawline?

No. Natural variation in bone structure, chin projection, muscle size and soft-tissue distribution means that jawlines differ considerably. An angular contour that suits one person may not be achievable or harmonious for another. Realistic expectations should be based on individual anatomy rather than comparison with photographs online.

Is facial or jawline slimming suitable for everyone?

No. A wider or fuller lower face may reflect natural bone structure, muscle bulk or soft-tissue distribution. In some people, natural fullness contributes to facial balance and youthful appearance. An assessment can help determine whether there is an identifiable concern that is appropriate to address, or whether maintaining the existing anatomy is the better choice.

What should I expect during a jawline consultation?

A consultation generally involves discussing your concerns and goals, medical history, assessing the face from the front and side, and examining relevant anatomical factors such as muscle activity, chin projection, bone structure, soft-tissue fullness and skin laxity. Your practitioner can then explain the relevant findings, discuss potential suitable options if appropriate, their limitations, risks, pricing, and help you with the next steps. Consultations do not guarantee treatment. Treatment results vary from person-to-person and from treatment-to-treatment.

What causes a short chin?

Posted on September 30, 2026September 30, 2026 by Michelle Dodd

A short chin can be caused by several different anatomical factors, including the underlying bone and jaw position, vertical chin height, muscle activity, the position of the lips, and changes to the surrounding soft tissues with age. Sometimes, more than one factor is present at the same time.

Importantly, a chin that looks short or recessed does not necessarily mean the chin itself is the problem.

When I assess the lower face, I look at the chin in relation to the lips, nose, jawline and overall facial proportions rather than assessing the chin in isolation. This is important because the same appearance can have very different underlying causes.

Short chin vs recessed chin: what is the difference?

The terms “short” and “recessed” are sometimes used interchangeably, but they describe different aspects of the chin.

A short chin generally refers to reduced vertical height – how long the chin appears from the front.

A recessed or regressed chin refers more to its position from the side profile – how far back the chin sits in relation to the lips, nose and rest of the lower face.

A person can have one without the other.

For example, someone may have reasonable vertical chin height but relatively little forward projection. Another person may have a chin that is both vertically short and positioned further back. Some people naturally have a smaller chin that is completely proportionate to the rest of their face.

There is no single chin length or degree of projection that is ideal for everyone.

What causes a short chin?

1. Bone and jaw position

The shape and position of the lower jaw are major factors in the appearance of the chin.

The chin is part of the mandible, so its position is influenced by the underlying skeletal structure and the relationship between the upper and lower jaws.

Dental and skeletal relationships can also affect the appearance of the profile. Malocclusion, for example, can alter the position of the lower jaw and therefore the apparent projection of the chin.

This is something I see in consultations: a person may present because they are concerned that their chin looks short or recessed, but when I assess the facial proportions, the underlying issue may be related to the bite or jaw position.

In some cases, the appropriate next step is an assessment by a dentist or another appropriately qualified practitioner. If the underlying cause is skeletal or dental, it is important to understand and address that cause rather than simply focusing on the appearance of the chin.

2. Vertical chin height

A chin can appear short because there is less vertical height between the lower lip and the bottom of the chin.

This is different from forward projection.

It is possible to have a chin that projects reasonably well from the side but still appears relatively short from the front. Conversely, someone can have a reasonable vertical height but less forward projection.

This is one reason why I assess the face from more than one angle.

Looking only at a frontal photograph can miss an important part of the picture.

3. Mentalis muscle activity

The mentalis muscle is another factor that can influence the appearance of the chin.

The mentalis is involved in movements of the lower lip and chin. Some people recruit the mentalis to help bring their lips together, particularly when their lips do not naturally meet comfortably at rest.

When the muscle contracts strongly, it can alter the appearance of the chin from the side profile and may contribute to a more bunched or dimpled appearance.

One patient I assessed was concerned because her chin appeared both “short” and dimpled. During the consultation, I asked whether she felt she had to push her lower lip upwards to close her lips.

She said yes.

On assessment, it became apparent that she was using her mentalis muscle to help close her mouth because her lips did not meet without that muscular effort.

That observation was important.

If someone relies on a muscle to help achieve lip closure, that functional aspect needs to be considered as part of the assessment before developing any treatment plan. The goal should never be to look at an isolated aesthetic feature without considering how the muscles and surrounding structures function.

4. The position and fullness of the lips

The lips can also change how the chin appears from the side.

For example, when the lips project significantly forward relative to the rest of the facial profile, the chin can appear further back by comparison.

This does not necessarily mean that the chin has changed.

It can be a matter of proportion.

I have seen patients present with concerns about chin recession when, on assessment, the position of the chin itself was actually reasonably proportionate to the nose and the rest of the profile.

In one consultation, I assessed the patient’s profile using established facial reference concepts, including the Ricketts E-line and Steiner S-line. These are cephalometric reference lines used in orthodontic and facial analysis to help assess the relationship between the lips, nose and chin.

These measurements are reference points rather than absolute rules. Facial proportions vary between individuals, and a person’s natural anatomy does not need to conform to a single numerical standard.

In this particular case, the chin itself appeared proportionate to the nose. The apparent imbalance was largely related to the prominence of the lips.

No treatment directed at the chin was recommended.

This is an important distinction: sometimes the most appropriate clinical decision is to recognise that the feature a person is concerned about is not actually the source of the imbalance.

5. Age-related changes around the chin

The appearance of the chin can also change as the face ages.

This is rarely due to one single process.

Age-related changes can include changes to the underlying bone, alterations in muscle activity, skin laxity, soft-tissue descent and changes in the distribution and prominence of fat around the lower face.

The jowl area is particularly relevant.

As the tissues of the lower face change with age, increased fullness and descent around the jawline can make the central chin appear smaller by comparison.

In other words, the chin may not actually have become substantially smaller – the surrounding structures have changed.

I have seen this in mature patients who feel that their chin has “disappeared” or become shorter with age. On assessment, the underlying chin projection can actually be quite good.

In one such consultation, the surrounding lower-face fullness, particularly around the jowl region, was contributing to the appearance of a smaller chin.

When the overlying skin was gently repositioned during assessment, more of the underlying mandibular contour and chin projection became visible.

This demonstrates why the chin should not be assessed independently from the jawline and surrounding soft tissues.

Can more than one factor cause a short chin?

These factors do not always occur separately.

A person may have naturally reduced chin projection combined with a shorter vertical chin. Someone else may have a skeletal difference together with increased mentalis activity. Another person may have a naturally proportionate chin but develop changes around the jawline with age that make the chin appear less prominent.

It can therefore be misleading to look at a patient and conclude that someone simply has a “small chin.”

The appearance is the end result of several anatomical relationships.

How I assess chin proportions

When assessing the lower face, I don’t look at the chin as an isolated feature.

I consider:

Vertical chin height — how long the chin appears from the front
Forward projection — how far the chin sits forward in profile
The underlying jaw and dental relationship
Mentalis activity and lip closure
The position and prominence of the lips
The relationship between the chin and nose
The jawline and surrounding soft tissues
Changes associated with ageing
Overall facial proportions

I may also use anatomical reference points and measurements as part of the assessment.

For selected consultations, ultrasound can provide additional information about individual anatomical variation. This can be particularly relevant in the lower face because important structures vary between individuals. For example, the location of the submental artery can vary and may be relevant when assessing the anatomy of the chin and submental region due to its connection with the sublingual artery (inside the mouth).

The purpose of this assessment is not to make every face conform to a particular measurement.

It is to understand the individual’s anatomy.

Your chin doesn’t have to look like someone else’s

One of the most important things to understand about chin proportions is that there isn’t one universally correct chin.

Some people naturally have a smaller chin and it suits their facial proportions.

Others naturally have a longer or more projected chin.

A chin that looks balanced on one face may look completely different on another because facial harmony depends on the relationship between multiple structures.

This is why I don’t assess the chin in isolation.

The lips, nose, cheeks, jawline and lower face all contribute to how the chin is perceived. Changes in one area can alter the apparent proportions of another.

You can read more about how I assess the chin and lower face as a whole in my guides to lip proportions and jawline anatomy, as well as my dedicated chin consultation page.

A concern about the chin may also form part of a broader consultation about facial ageing, wrinkle reduction, or changes associated with volume loss, depending on the individual’s anatomy and concerns.

The important question isn’t simply “How do I make my chin bigger?”

It is:

Why does the chin look short or recessed in the first place?

That distinction matters.

The appearance may be related to bone, jaw position, vertical height, muscle activity, lip position, ageing changes around the lower face – or a combination of several factors.

Sometimes the chin itself is the main consideration.

Sometimes it isn’t.

A thorough assessment can help distinguish between the feature that is causing the concern and the feature that is actually creating the appearance.

For me, that is the starting point: understand the anatomy first, then decide whether anything actually needs to be changed.

Frequently Asked Questions

What causes a short chin?

A short chin can have several causes, including reduced vertical chin height, the underlying shape and position of the jaw, changes in the surrounding soft tissues, mentalis muscle activity and the relationship between the chin, lips and nose. More than one factor can be present at the same time.

What is the difference between a short chin and a recessed chin?

A short chin generally refers to reduced vertical height – how long the chin appears from the front. A recessed or regressed chin refers more to how far back the chin sits in relation to the lips and nose when viewed from the side. A person can have one or both.

Can ageing make your chin look smaller?

Yes. Changes to the underlying bone, skin laxity, soft-tissue descent, changes in fat distribution around the lower face and changes in muscle activity can all alter the appearance of the chin as we age. Sometimes the chin itself has good projection, but changes around it make it appear less prominent.

Can your lips make your chin look recessed?

Yes. The relative position and prominence of the lips can affect how the chin appears from the side. If the lips project further forward in relation to the rest of the facial profile, the chin can appear more recessed by comparison.

Can your bite affect the appearance of your chin?

Yes. The relationship between the upper and lower jaws and certain dental or skeletal abnormalities can affect the position and appearance of the chin. If the underlying concern is related to the bite or jaw position, assessment by an appropriately qualified dental or medical professional may be appropriate.

Why does my chin look short when I smile or close my mouth?

Muscle activity can change the appearance of the chin. Some people recruit the mentalis muscle to help bring their lips together, particularly when their lips do not naturally meet comfortably at rest. This can alter the appearance of the chin and should be considered when assessing the lower face.

Can a short chin also be a long chin from the side?

Yes. Vertical height and forward projection are different characteristics. A chin may have reasonable vertical length but sit relatively far back in profile, or it may have limited vertical height while still having reasonable forward projection.

Does everyone need the same chin proportions?

No. Facial proportions vary considerably between individuals. A smaller chin can be completely harmonious with one person’s facial structure, while another person may naturally have a longer or more projected chin. There isn’t one universal chin measurement that suits every face.

How do you assess whether a chin is actually short or recessed?

I assess the chin from multiple angles and consider its relationship with the lips, nose, jawline and overall facial proportions. I also consider factors such as mentalis activity, lip closure, the underlying jaw and dental relationship, and age-related changes to the surrounding tissues. In selected consultations, ultrasound may also provide information about individual anatomical variation.

Can a chin concern actually be caused by the jawline?

Yes. Changes around the jawline, particularly increased fullness and soft-tissue descent around the jowls with age, can make the central chin appear smaller or less prominent by comparison. In these cases, the chin itself may not be the primary cause of the appearance.

Can a chin look short because of more than one cause?

Yes. For example, someone may have naturally reduced chin projection combined with a shorter vertical height, or skeletal anatomy combined with mentalis activity. Ageing can also involve several changes simultaneously. This is why I don’t assess one feature in isolation.

Should I have my chin assessed if I think it is too short?

An assessment can help determine what is actually contributing to the appearance. The important question isn’t simply whether a chin looks short or recessed, but why. In some cases, the chin itself may be the main consideration; in others, the surrounding anatomy, jaw position, dental relationship or facial proportions may be more relevant.

What is the best treatment for nasolabial folds?

Posted on September 16, 2026September 16, 2026 by Michelle Dodd

There is no single “best” treatment for nasolabial folds because there is no single cause of them. The appropriate approach depends on whether the appearance is primarily related to superficial skin creasing, facial movement, changes in underlying bone, mid-face changes, nasolabial fat, or a combination of factors.

A nasolabial fold may be a superficial crease in the skin caused largely by facial movement, a shadow related to changes in the bone around the base of the nose, or a fold created by changes in the mid face and nasolabial fat. Often, more than one of these factors is present at the same time.

This is why I don’t believe the visible line should automatically be treated simply because it is there.

The first step is understanding why that particular nasolabial fold is present, and whether treatment is appropriate at all.

What are nasolabial folds?

Nasolabial folds are the natural lines that run from the sides of the nose towards the corners of the mouth.

They are a normal part of facial anatomy and facial expression. They become more visible when we smile, laugh and talk, because the skin and underlying tissues naturally move and fold.

In fact, nasolabial folds aren’t something that only appear with ageing. Even babies have them.

What changes with age is the appearance and prominence of these folds.

This distinction is important because the goal shouldn’t necessarily be to completely eliminate a nasolabial fold. In many people, trying to make the area completely smooth can produce a result that looks less natural, particularly when the person smiles or talks.

For most patients, the more appropriate goal is to soften the appearance of the fold while maintaining natural facial movement and expression.

Why do nasolabial folds become more prominent with age?

There isn’t one anatomical change responsible for every nasolabial fold.

As the face ages, changes can occur in the skin, fat compartments and underlying bone. These changes can alter the support and contours of the mid face and make an existing nasolabial fold appear deeper or more noticeable.

Changes in the mid-face

The mid-face provides important structural support to the tissues above and around the nasolabial region.

With ageing, there can be changes in the volume and position of the facial fat compartments, as well as changes to the underlying facial bones.

When the mid face loses some of its structural support, the skin and soft tissues can appear to “sink” and descend.

This can make the area around the nasolabial fold appear more pronounced.

Volume loss assessments for the mid-face form part of the nasolabial fold consultation.

Changes in the nasolabial fat

An interesting aspect of facial ageing is that not all facial fat simply depletes.

Some research has demonstrated that the nasolabial fat compartment can actually increase in size with age, while also changing position.

This is important because it challenges the common idea that every facial fold is simply caused by a lack of volume.

The appearance of the nasolabial fold can be influenced by the relationship between neighbouring structures. If the mid-cheek loses support and becomes more recessed, the nasolabial fat can appear increasingly prominent next to it.

The result can be a more noticeable fold or transition between the cheek and upper lip.

This is one reason why treating only the visible line doesn’t always address the underlying cause.

How I assess the nasolabial folds

When assessing a patient, I don’t simply look at how deep the fold appears.

I look at what the fold actually looks like and where the prominence is coming from.

There are several patterns I commonly consider.

1. A superficial crease in the skin

Some people have a relatively fine crease that is etched into the skin.

This can be particularly noticeable when they smile or animate.

In these cases, facial movement and muscle activity may be contributing significantly to the appearance of the crease.

This is quite different from a deep shadow created by a loss of underlying structural support.

Approaches to support the skin quality and assist in collagen production for superficial creases may be discussed, including wrinkle-reduction and Rejuran options.

2. Shadowing beside the nose

Another presentation is a deeper-looking shadow or groove next to the nostril.

In some patients, this appearance can be associated with changes in the underlying bone around the nasal opening, including resorption around the piriform aperture.

This can create a shadow that makes the nasolabial region appear deeper even when the skin itself isn’t necessarily the main problem.

Shadowing next to the nose is the only ‘volume loss‘ that occurs in the nasolabial fold.

Aesthetic ultrasound may be used in volume loss consultations to identify individual anatomy of the nasolabial fold.

3. Folding of the nasolabial skin

Some patients have more prominent nasolabial tissue and a visible fold where the skin sits over this area.

Changes in the nasolabial fat, combined with loss or repositioning of mid-face fat and changes in underlying bone support, can contribute to this appearance.

These different presentations can look superficially similar in a photograph, but they don’t necessarily have the same underlying cause.

And sometimes, a patient has two or more contributing factors at the same time.

Why I don’t automatically treat the nasolabial fold itself

One of the most common misconceptions I see is:

“I can see a line, so the line must be where the problem is.”

Facial ageing doesn’t work quite that simply.

A visible line can be the result of changes occurring somewhere else.

For example, imagine a patient who has lost support through the mid-face. Changes in the facial fat compartments and underlying bone can alter the contour of the cheek. The resulting change in support can make the nasolabial region appear more prominent.

In that situation, simply focusing on the line may not be the most appropriate way to approach the concern.

This is why I assess the whole mid face and surrounding anatomy, rather than looking at the nasolabial fold in isolation.

Your age isn’t necessarily an indication of how deep your folds should be

Age is certainly relevant to facial ageing, but chronological age doesn’t tell me everything I need to know.

I’ve seen patients in their early thirties with quite prominent nasolabial folds, while some patients around 50 have relatively subtle folds.

Genetics, facial anatomy, bone structure, fat distribution, facial movement and changes in weight can all influence how prominent a person’s nasolabial folds appear.

For a younger patient who appears to have experienced a noticeable loss of facial volume, weight loss may also be a contributing factor.

A significant change in body weight can alter facial volume and therefore change the appearance of the nasolabial region, even when someone isn’t experiencing the same age-related changes as an older patient.

I also consider dental position and bite position in some patients, as they may be relevant to the facial structure and appearance.

Static and dynamic assessment are both important

A person’s face isn’t static.

We smile, laugh, talk and express emotion throughout the day.

For this reason, I don’t assess nasolabial folds only when a patient is sitting completely still.

I look at the face at rest and during movement.

A fold that appears noticeable when someone is smiling may be completely normal facial movement. Trying to eliminate that movement-related fold entirely could create an unusual or unnatural appearance when the person is animated.

This is particularly important when patients are comparing themselves with photographs they have seen online.

Why social media can create unrealistic expectations

One of the problems with treating facial folds today is that people are constantly exposed to images of faces that don’t necessarily represent real-life anatomy.

Filters, retouching and carefully selected photographs can make it appear as though completely smooth skin is the normal expectation.

It isn’t.

A real face has folds, creases, shadows and movement.

The nasolabial fold naturally becomes more pronounced when we smile, laugh and talk. Expecting it to remain completely flat throughout all facial expressions isn’t necessarily a realistic or desirable outcome.

I often tell patients that the goal is to soften, not eliminate.

Why treating a nasolabial fold may not be appropriate

Some people come to a consultation concerned about what I would consider a normal amount of fine creasing or shadowing.

In these situations, treatment isn’t necessarily the answer.

If I believe that attempting to completely remove a normal anatomical feature is likely to result in an unnatural appearance, I will explain that to the patient.

There are also situations where a patient’s expectations aren’t realistic enough for me to recommend treatment.

I would rather tell someone that I don’t think treatment is appropriate than perform a treatment simply because they have requested it.

In some circumstances, a patient may also be better suited to an alternative treatment approach or another practitioner, and I may recommend that they seek a different opinion.

Why over-treating the area can look unnatural

One of the potential problems with trying to completely flatten the nasolabial region is that the natural transition between the cheek and upper lip can be lost.

If the area becomes excessively full, the cheek can appear to blend into the upper lip region, producing what I sometimes describe to patients as a “chipmunk” appearance.

The face can look smoother while simultaneously looking less natural.

This is why I don’t believe that “more treatment” automatically means a better result.

Chasing perfection can sometimes take us further away from what looks natural.

So, what is the best treatment for nasolabial folds?

The answer is:

The best treatment is the treatment that addresses the underlying cause of the particular nasolabial fold, if treatment is appropriate at all.

For one person, facial movement and superficial skin creasing may be an important contributor.

While another persons nasolabial fold appearance may be influenced by structural changes around the piriform aperture.

And another person may have changes in the mid-face, including changes in cheek fat volume and position, nasolabial fat prominence and underlying bone support.

And for many people, there will be a combination of factors.

This means that there isn’t a universal treatment that can be labelled the “best treatment for nasolabial folds”.

It also means that treatment doesn’t necessarily need to be directed into the visible fold itself.

Why a consultation is important

A proper assessment allows me to determine what is contributing to the appearance of the nasolabial region, whether treatment is likely to produce a meaningful improvement, and whether the patient’s expectations are realistic.

I assess the fold at rest and during facial movement, consider the surrounding anatomy and look at how different areas of the face relate to one another.

I also consider factors such as age, genetics, facial structure, changes in weight, mid-face volume and, where relevant, dental position.

The treatment plan should come after this assessment, not before it.

This is particularly important when someone arrives at a consultation already convinced that they need a specific treatment because they have seen it recommended online.

The treatment that is appropriate for someone else’s nasolabial folds isn’t necessarily the treatment that is appropriate for yours.

The bottom line

Nasolabial folds are a normal part of facial anatomy.

They don’t need to be completely removed, and in many cases, attempting to do so can create an unnatural appearance.

The most important question isn’t simply:

“How do I get rid of my nasolabial folds?”

It is:

“Why are my nasolabial folds prominent?”

Once the underlying anatomy and contributing factors have been identified, it becomes possible to determine whether treatment is appropriate and, if so, what approach may be suitable.

For me, this is the most important part of treating any facial ageing concern:

Technique should follow diagnosis, not the other way around.

Frequently Asked Questions

What is the best treatment for nasolabial folds?

There is no single best treatment for everyone. Nasolabial folds can have different causes, including superficial skin creasing, facial movement, changes in the bone around the piriform aperture, changes in the mid-face fat compartments and changes in the nasolabial fat. A consultation is important to identify the contributing factors before deciding whether treatment is appropriate.

Can nasolabial folds be completely removed?

Usually, the goal should be to soften rather than completely eliminate a nasolabial fold. Nasolabial folds are a normal part of facial anatomy and naturally become more prominent with smiling, talking and laughing. Completely flattening them can result in an unnatural appearance.

Why are my nasolabial folds deep even though I’m young?

Age is only one factor. Genetics, facial anatomy, bone structure, fat distribution, facial movement and changes in body weight can all influence the appearance of nasolabial folds. Some younger people naturally have more prominent folds than others.

Are nasolabial folds caused by loss of facial fat?

Facial ageing involves changes in both the volume and position of different fat pads. Some research has found that the nasolabial fat compartment can increase in size with age, while fat in the mid-face decreases in size with age. Changes in the mid-face can therefore make the nasolabial region appear more prominent without the problem simply being a lack of volume.

Does treating the nasolabial fold itself always work?

Not necessarily. The visible fold may be the result of changes in surrounding structures, such as the mid face or underlying bone, rather than being an isolated problem with the fold itself. This is why assessment of the whole area is important.

Why do my nasolabial folds disappear when I change my facial expression?

Facial movement can contribute significantly to the appearance of some nasolabial creases. Assessing the face both at rest and during movement helps determine how much of the appearance is related to normal facial animation.

Should everyone have their nasolabial folds treated?

No. Nasolabial folds are a normal and proportionate feature of the face, and treatment may not provide a worthwhile or natural-looking improvement. In some patients, the most appropriate recommendation is not to treat the area.

What Are the Best Treatments for Neck Wrinkles and Sagging Neck Skin?

Posted on August 25, 2026August 25, 2026 by Michelle Dodd

There is no single best treatment for neck wrinkles and sagging neck skin. The most appropriate approach depends on whether the main concern is horizontal neck lines, crepey skin, true skin laxity, or platysmal bands, as these concerns have different underlying causes.

Non-surgical treatments may address skin quality, hydration, texture, collagen support and the appearance of some wrinkles, but they cannot remove significant excess skin or reproduce a surgical lift. A personalised assessment is therefore important to determine what is actually causing the concern and what level of improvement is realistically achievable.

The three most common neck concerns I see

When someone tells me they don’t like the appearance of their neck, I first try to understand exactly what they are seeing.

There are three concerns I see particularly often:

Horizontal neck lines, sometimes called necklace lines or “tech neck”
Crepey or sagging neck skin
Platysmal bands, vertical bands created by the platysma muscle

These concerns can occur independently, but they can also occur together.

The difference matters because treating skin texture won’t necessarily correct muscle bands, and trying to improve genuine excess skin with a treatment designed primarily to improve skin quality is unlikely to produce the result someone may be hoping for.

1. Horizontal neck lines

Horizontal neck lines are static, etched-in lines that run across the front of the neck. They are often referred to as “necklace lines”, or “tech neck”.

Are all horizontal neck lines caused by “tech neck”?

Looking down repeatedly at a phone, laptop or computer can contribute to the formation or worsening of horizontal neck lines. If you spend many hours with your head positioned downwards, the neck repeatedly folds in the same place.

However, not all horizontal neck lines are caused by looking down at a computer or phone.

Genetics, skin structure, sun exposure, skin quality and individual anatomy can all play a role. Some people will develop prominent horizontal lines much earlier than others, even when they don’t have significant skin laxity.

I have seen patients who are relatively young, have good overall skin quality and no obvious signs of general skin laxity, yet have prominent horizontal neck lines.

One patient said she could remember having these lines since her teenage years.

Can horizontal neck wrinkles be completely removed?

This is where I think realistic expectations are particularly important.

Once horizontal lines have been deeply etched into the skin over many years, they will not generally completely disappear.

Depending on the individual and the cause, treatments aimed at improving skin quality may soften the appearance of lines, but complete removal is often unrealistic.

Our goal should not be to make the neck look as though it has never moved or aged. The aim is to improve what is realistically achievable for that person’s skin.

What can help?

Different approaches may be considered depending on the individual, including treatments that support collagen production and skin quality, energy-based approaches and appropriate home skincare.

For example, Rejuran is one treatment where skin quality is part of the concern. Rejuran is a polynucleotide treatment designed to support collagen and elastin production and improve aspects of skin quality, hydration and texture. Suitability and treatment planning are individual. You can read more about Rejuran treatments on our Rejuran page.

Rejuran and other collagen-stimulating approaches are generally not “one treatment and done” treatments. They are often designed as a course of treatments, with improvements developing over time rather than appearing immediately after one session.

Home care is also important.

A simple starting point for many people is to stop treating the neck as though it is a completely separate part of the body and extend appropriate facial skincare down onto the neck.

This may include:

an antioxidant such as vitamin C
vitamin A/retinoid products where appropriate
moisturiser
daily broad-spectrum sunscreen

However, skincare is individual. Some people can become irritated by vitamin A or vitamin C, and vitamin A products are not appropriate during pregnancy or breastfeeding. The thin skin of the neck can also be more sensitive than facial skin, so products should be introduced appropriately for the individual.

If looking down for long periods is contributing to your lines, simple behavioural changes can also help. Adjust your computer screen so that you aren’t constantly looking down, and be conscious of your head and neck position when using your phone.

2. Crepey and sagging neck skin

“Loose skin” is often used to describe any neck that doesn’t look completely smooth, but there is an important difference between crepey skin texture and genuine skin laxity.

Someone can have crepey skin without having significant laxity.

Crepey skin may be related to changes in the surface and quality of the skin, including sun damage. It can appear thin, with fine a lined and wrinkled texture, even when the underlying skin still has reasonable elasticity.

This is different from someone who has genuine loss of skin elasticity and excess skin.

How do I assess neck skin laxity?

This is something I assess by looking and by touch.

Mild skin laxity can sometimes be visible as thin, loose skin, particularly around the upper neck underneath the jawline. It can become more apparent from a side profile or when someone turns their head.

I also use clinical observation of skin turgor (how the skin returns after it has been gently pinched).

If the skin returns quickly or “snaps back”, this suggests better elasticity. If the skin remains where it was pinched and returns more slowly, or not at all, there may be reduced elasticity and loss of the skin’s ability to recoil.

This is only one part of an overall assessment, but it helps distinguish different types of skin concerns.

Why does this distinction matter?

Because crepey skin and significant excess skin aren’t the same problem.

If the primary concern is skin texture, improving skin quality, hydration and collagen support may be relevant.

If there is significant excess or lax skin, however, non-surgical skin treatments cannot replicate what surgery does.

Non-surgical treatments can support collagen production, hydration, skin texture and the appearance of fine lines. They cannot remove excess skin or surgically reposition tissue.

This is why I think it is important to be honest about what a treatment can realistically achieve.

If someone has significant laxity and is looking for a dramatic lifting effect, I may explain that I don’t believe the treatments available to me will produce the result they are hoping for. Some people are still happy with a more subtle improvement and others decide that the expected difference isn’t enough to make treatment worthwhile.

There is nothing wrong with either decision.

You can learn more about approaches to skin quality and hydration with a Skin Hydration Consultation.

3. Platysmal bands

Platysmal bands are different again.

The platysma is a broad, sheet-like muscle that extends through the neck. When it contracts, vertical bands can become visible.

In younger people, these bands are often not particularly noticeable at rest. They may become visible when the platysma contracts. For example, when making certain facial expressions.

As we get older, platysmal bands can become more prominent and may be visible even when the neck is at rest.

This is important because platysmal bands are a muscle-related concern, not simply loose skin.

Someone may look at their neck and think, “My skin is sagging,” when part of what they are actually seeing is muscle banding.

The appropriate approach therefore depends on what is creating the appearance.

If you are concerned about neck bands or movement-related wrinkles, a Wrinkle Reduction Consultation allows the movement and skin to be assessed rather than assuming that every visible line is caused by lax skin.

Why there isn’t one “best” neck wrinkle treatment.

This is probably the most important thing I would want someone to understand before searching for a treatment.

There isn’t one best treatment for neck ageing.

A person may have:

deep horizontal neck lines
crepey skin
mild skin laxity
platysmal bands
sun damage
changes in the submental area
or a combination of several of these.

The treatment plan needs to reflect the underlying cause.

For example, if someone has a surface skin-quality concern, the approach may focus on improving the skin itself.

If someone has significant laxity, the conversation is different.

If the concern is primarily muscle-related, that is different again.

And if changes in the chin, jawline or surrounding facial structure are contributing to how the neck looks, the neck shouldn’t necessarily be assessed in isolation. Changes in facial volume and structure can influence the appearance of the lower face and neck. A Volume Loss Consultation can be useful when volume or structural changes are part of the concern.

This is why I prefer an assessment-led approach rather than recommending a particular treatment before seeing someone.

Do neck treatments need to be repeated?

Often, yes.

One of the misconceptions I hear is:

“I had one treatment and didn’t see a difference, so it didn’t work.”

Some collagen-stimulating and skin-quality treatments are designed to be performed as a course rather than a single session. The biological changes also take time.

If a treatment plan involves multiple sessions, completing only the first treatment may not give you a fair indication of the eventual result.

This doesn’t mean everyone needs a particular number of treatments. The appropriate plan depends on the individual, the treatment being considered and the concern being addressed.

But it is important to understand the difference between a treatment designed to create an immediate visible change and one that works gradually by supporting changes within the skin.

Can skincare help with neck wrinkles?

One of the simplest things people can do is also one of the things I see neglected most often:

Take your skincare down to your neck.

Many people concentrate on their face, but stop their skincare at the jawline.

The neck is exposed to the same environment as the face, including ultraviolet radiation, yet it is often overlooked when sunscreen and other skincare products are applied.

As a general starting point, appropriate sunscreen every day is one of the most important habits for protecting the skin from further photo damage.

Other products, such as antioxidants, moisturisers and vitamin A products, may have a role depending on the individual. However, neck skin can be sensitive, so introducing active skincare isn’t necessarily as simple as using everything you use on your face.

What I think people get wrong about treating the neck.

After more than 12 years working in aesthetic medicine, there are three misconceptions I hear repeatedly.

1. One treatment should fix everything

Neck ageing can have multiple causes, so expecting one treatment to address every concern is unrealistic.

Sometimes a combination of approaches is required because there is more than one contributing factor.

2. Non-surgical treatments can produce a surgical result

They can’t.

If you pull loose skin up underneath your jaw and say, “That’s the result I want,” it is important to understand that a non-surgical skin treatment cannot simply reproduce that result.

Non-surgical treatments can improve aspects of skin quality, texture, hydration and collagen support. They do not remove excess skin or surgically reposition tissue.

3. Deep wrinkles should disappear completely

A deeply etched horizontal neck line that has been present for many years may soften with appropriate care, but expecting it to disappear completely is often unrealistic.

We also need to accept that we cannot remain completely wrinkle-free as we age.

Even with excellent skincare and appropriate aesthetic treatments, skin continues to age.

The goal isn’t to look 20 forever. It is to make the most of the skin you have now and maintain it as well as possible over time.

What are the best treatments for neck wrinkles and sagging skin?

The answer depends on which neck concern you have and how significant it is.

Horizontal lines, crepey skin, laxity and platysmal bands are all different concerns, so they shouldn’t automatically be treated in the same way.

My approach is to first assess the neck and identify the contributing factors. From there, appropriate options can be discussed based on your anatomy, skin quality, goals and expectations.

Sometimes, several treatment modalities are appropriate.

And sometimes, if the degree of laxity or excess skin is significant, I will be honest and say that I don’t believe the non-surgical options I can offer will make enough difference to achieve the result someone wants.

I think that is an important part of ethical aesthetic practice.

The best treatment isn’t necessarily the most intensive treatment. It is the treatment, or combination of approaches, that makes sense for the actual cause of your concern and the result you can realistically achieve.

If you are concerned about neck lines, wrinkles, skin texture, laxity or platysmal bands, a personalised Neck Consultation can help determine what is contributing to the appearance of your neck and what options may be appropriate for you.

Frequently Asked Questions

What is the best treatment for neck wrinkles?

There is no single best treatment for everyone. The appropriate approach depends on whether the main concern is horizontal lines, skin texture, skin laxity, sun damage, platysmal bands or a combination of factors. A personalised assessment is the best way to determine which options may be appropriate.

Can neck wrinkles be completely removed?

Deep, static horizontal neck lines that have been etched into the skin for many years generally cannot be expected to disappear completely. Appropriate treatments may soften their appearance, but completely wrinkle-free skin is usually an unrealistic goal.

What causes horizontal neck lines?

Horizontal neck lines can be influenced by genetics, repeated neck movement and positioning, sun exposure, skin quality and individual anatomy. Looking down at phones and computers can contribute to their development or worsening, but not every horizontal neck line is caused by “tech neck”.

What is the difference between crepey skin and sagging skin?

Crepey skin refers primarily to changes in skin texture and can occur without significant laxity. Sagging or lax skin involves reduced elasticity and, in more significant cases, excess skin. These concerns may require different approaches.

How can I tell if I have loose skin on my neck?

Skin laxity can be assessed by looking at the neck from different angles and gently assessing the skin. Skin turgor, or how quickly the skin returns after being gently pinched, can provide an indication of skin elasticity. A professional assessment can help distinguish laxity from other causes of neck ageing.

What are platysmal bands?

Platysmal bands are vertical bands caused by contraction of the platysma muscle in the neck. They can be more apparent during muscle contraction when someone is younger and may become increasingly visible at rest with age.

Does “tech neck” cause neck wrinkles?

Repeatedly looking down at phones, computers and other devices can contribute to repeated creasing of the neck and may worsen horizontal lines. However, genetics and other factors also influence neck wrinkles, so not all horizontal lines are caused by technology use.

How many treatments are needed for neck wrinkles?

The number of treatments depends on the concern and the approach being considered. Some collagen-stimulating treatments are designed as a course of multiple sessions and produce gradual changes rather than an immediate result after one treatment. Your recommended treatment plan should be individualised following assessment.

Can skincare help neck wrinkles?

Appropriate skincare may support skin health and help address factors such as dryness, photo damage and skin texture. Daily sunscreen is particularly important. Products containing vitamin A or vitamin C may be appropriate for some people, but neck skin can be sensitive and individual suitability varies.

Can non-surgical treatments remove sagging neck skin?

Non-surgical treatments may improve aspects of skin quality, hydration, texture and collagen support, but they cannot remove significant excess skin or reproduce the tissue repositioning achieved through surgery. Expectations should be realistic when considering non-surgical treatment.

When should I have a neck consultation?

A consultation may be appropriate if you aren’t sure what is causing the appearance of your neck, particularly if you have a combination of lines, crepey skin, laxity or neck bands. The purpose of an assessment is to identify the contributing factors and determine what options, if any, may be appropriate.

What Causes Jowls? Understanding Why They Develop and Your Treatment Options

Posted on July 9, 2026July 13, 2026 by Michelle Dodd

If you’re wondering what causes jowls, the answer is that they are usually caused by a combination of age-related changes rather than a single problem. As we age, jowl fat can enlarge and shift downwards, skin and connective tissues become less supportive, the jaw bone resorbs and tissue begins to collect behind retaining ligaments, creating the appearance of a jowl. While some non-surgical treatments may help the surrounding facial support or disguise early jowls in selected patients, there is currently no non-surgical treatment that removes jowls completely. The most appropriate approach depends on the cause, severity and your individual facial anatomy.

What are jowls?

Jowls are the areas of tissue that develop along the lower jawline, usually on either side of the chin. They often make the jawline appear less defined and are one of the most common concerns I see during facial ageing consultations.

Interestingly, when patients tell me they are worried about their jowls, they are usually pointing directly at the jowl itself, not necessarily the jawline or neck. Understanding exactly what someone is concerned about is an important part of assessing the underlying cause.

What actually causes jowls?

One of the biggest misconceptions is that jowls are simply caused by “loose skin.”

In reality, they usually develop because several changes occur together over many years.

Changes in facial fat

Facial fat doesn’t simply disappear with age.

Different fat compartments behave differently. In the lower face, fat can enlarge or change position over time. Combined with weakening support from the surrounding tissues, this can contribute to fullness along the jawline.

Skin and connective tissue changes

Our skin gradually loses collagen and elasticity with age.

The connective tissues that support the face also become less supportive over time. This allows tissues to descend more easily.

Retaining ligaments

One of the most important contributors is the retaining ligaments of the face.

As the surrounding tissues descend, they can collect or “pool” behind these ligaments. Rather than everything moving evenly downward, the ligaments hold certain areas in place while tissue gathers beside them, creating the characteristic appearance of a jowl.

This is one reason why jowls are rarely caused by a single factor. To learn more about jawline anatomy, visit our jawline page.

Why treating jowls can be challenging

Because jowls develop from several different anatomical changes, there is rarely one simple solution.

Many patients arrive believing there is a single treatment that will “remove” their jowls. Unfortunately, that’s not how facial ageing works.

The treatment options depend on:

skin quality
skin thickness
facial bone support
facial volume
overall facial proportions
severity of the jowl
your goals and expectations

Every assessment is different.

Can volume replacement get rid of jowls?

This is probably the biggest misconception I see.

Many people believe adding volume treatments along the jawline will remove a jowl.

Sometimes, select patients with mild changes may see a disguised the transition between the jowl and surrounding tissues. During a consultation, I assess areas such as the pre-jowl and post-jowl regions to determine whether a small amount of support may improve the overall contour.

However, this does not remove the jowl itself.

If the jowl is already significant, adding increasing amounts of volume to disguise it can make the lower face appear wider or heavier.

In women especially, we generally aim to maintain a more balanced distribution of facial volume rather than creating excessive fullness in the lower face.

A common example I see in practice

One situation I occasionally see is patients who have previously had repeated lower-face volume treatments elsewhere because they were hoping to improve their jowls.

Although the jawline may appear fuller, the jowl itself often remains.

Instead of creating a more defined jawline, the additional volume can sometimes make the lower face look “heavier”, or more “masculine” with a wider, squarer jawline without addressing the underlying cause of the concern.

This is one reason why understanding why the jowl has developed is far more important than simply adding more volume.

Is referral for a consultation with a specialist plastic surgeon recommended?

Sometimes.

This can be a difficult conversation, but I believe it’s important to set realistic expectations.

If someone has significant skin laxity and heavier jowls, there is currently no non-surgical treatment that can remove the excess tissue.

Rather than recommending treatments that are unlikely to achieve the result someone is hoping for, I prefer to have an honest discussion about what can realistically be achieved.

For some patients who are open to it, a consultation with a plastic surgeon may be the most appropriate option to discuss surgical management.

Are there non-surgical options?

During a personalised consultation, we assess whether there are aspects of facial ageing that may be appropriate to address.

Depending on your individual assessment, recommendations may focus on improving skin quality and support with treatments such as Rejuran, or addressing surrounding facial changes that can influence the appearance of the lower face including wrinkle treatments.

However, it is important to understand that these approaches do not remove the jowl itself, and results vary depending on the underlying cause and severity.

The most appropriate recommendations can only be made after a comprehensive facial assessment.

How I assess patients concerned about jowls

Every consultation begins with understanding what concerns you most.

From there, I perform a comprehensive facial assessment rather than looking only at the jowl itself.

This includes assessing:

facial bone support
skin quality
skin thickness
skin laxity
the midface and lateral face
areas around the jowl, including the pre-jowl and post-jowl regions
overall facial balance

When appropriate, I also use facial ultrasound before volume loss consultations as part of my commitment to patient safety. Ultrasound is used for vascular mapping prior to treatment rather than assessing the cause of jowls themselves.

My approach

One of the most important parts of my job is helping patients understand what is—and isn’t—realistically achievable.

Sometimes, the right recommendation is no treatment.

If I don’t believe a non-surgical approach is likely to achieve your goals, I’ll tell you. I would rather have an honest conversation than recommend treatments that are unlikely to provide the improvement you’re hoping for.

Frequently Asked Questions

What causes jowls?

Jowls develop due to a combination of age-related changes, including facial fat redistribution, skin and tissue laxity, and changes in facial support structures.

Can you get rid of jowls without surgery?

There is currently no non-surgical treatment that removes jowls completely. In some patients, certain approaches may improve surrounding facial support or soften the appearance of early jowls, but they cannot remove excess tissue or stop the ageing process.

Why do my jowls seem to get worse every year?

Ageing is progressive. Changes in facial fat, skin, connective tissues and bone continue over time, which is why jowls often become more noticeable with age.

Is everyone with jowls a candidate for non-surgical treatment?

No. The most appropriate management depends on the cause and severity of the jowls and your treatment goals. In some cases, you may be referred to have a consultation with a specialist plastic surgeon to discuss your concerns.

Why Facial Ageing Is Not Just About Wrinkles

Posted on February 4, 2026April 3, 2026 by Michelle Dodd

Facial ageing is often misunderstood as being caused primarily by wrinkles. While wrinkles are a visible feature of ageing, they represent only one part of a much broader and more complex process.

Age-related changes to the face occur across multiple layers, including bone, fat, muscle, and skin. Understanding these changes is essential when assessing facial concerns and planning appropriate, individualised aesthetic care.

Facial Ageing Occurs in Layers

Ageing does not affect the face uniformly. Instead, it involves gradual structural and tissue changes beneath the skin that influence overall facial shape, support, and balance.

Bone Changes

As we age, bone resorption occurs. This process leads to a gradual reduction in bone density and structural support, particularly in areas such as the jaw, cheekbones, and eye sockets. These changes alter the foundation that supports overlying soft tissues.

Fat Pad Shifts and Volume Changes

Facial fat pads can shrink, shift, or descend over time. This contributes to hollowing, flattening, and loss of youthful contours, particularly in the mid-face and under-eye region.

Muscle Activity

Repetitive facial movement in areas such as the forehead, frown lines, or around the sides of the eyes plays a role in dynamic lines, but muscle activity alone does not account for broader facial ageing patterns. Muscle-related changes often interact with underlying volume and structural shifts.

Skin Quality Changes

Collagen, elastin, and hydration levels decline with age. Reduced skin elasticity and resilience can accentuate shadows, folds, and textural changes, even when wrinkles are minimal.

Why Treating Wrinkles Alone Is Often Insufficient

Focusing solely on wrinkles without assessing the broader facial structure can lead to incomplete or unbalanced outcomes. Wrinkles may be a symptom of deeper changes rather than the primary cause of facial ageing.

A comprehensive facial assessment considers:

Structural support
Volume distribution
Skin quality
Muscle movement
Individual anatomy

This layered approach supports more informed decision-making and realistic expectations.

The Role of Assessment in Facial Ageing Concerns

Because facial ageing is multifactorial, assessment is a critical first step. A consultation for volume loss allows time to evaluate the underlying contributors to visible ageing and discuss suitable options based on individual needs.

In selected consultations, ultrasound-guided assessment may be used to visualise underlying facial structures. This can support anatomical understanding and enhance safety when planning aesthetic care.

Why a Consultation-Led Approach Matters

A consultation-led approach prioritises education, safety, and personalised care. Rather than treating isolated features, this process focuses on overall facial balance and long-term outcomes.

This approach helps ensure that recommendations are:

Appropriate for your anatomy
Aligned with your goals
Based on evidence and clinical assessment
Respectful of natural facial expression

Final Thoughts

Facial ageing is not just about wrinkles. It is a gradual, layered process influenced by structural, volumetric, muscular, and skin-related changes. Understanding these factors allows for a more thoughtful and personalised approach to aesthetic care.

If you’re considering aesthetic treatment, a consultation provides an opportunity for a personalised assessment, discussing suitability, treatment options, and individual considerations.

Frequently Asked Questions

What causes facial ageing?

Facial ageing is influenced by changes in bone structure, fat distribution, muscle activity, and skin quality. These factors interact over time, leading to visible changes in facial shape and texture.

Are wrinkles the main sign of facial ageing?

Wrinkles are one visible feature, but they do not account for all ageing-related changes. Structural support, volume loss, and skin quality play significant roles.

Why is volume loss important in facial ageing?

Volume loss affects facial contours and support, contributing to hollowing and sagging. It often underlies changes that may not be addressed by focusing on wrinkles alone.

How does a facial assessment help?

A facial assessment evaluates anatomy, movement, and skin quality to identify contributing factors to ageing. This supports personalised and appropriate treatment planning.

What is the role of ultrasound in facial assessment?

Ultrasound may be used in selected cases to visualise underlying facial structures. This supports anatomical understanding and can enhance safety when planning aesthetic care.

How the Face Ages Over Time – Skin, Fat and Bone

Posted on February 2, 2026April 5, 2026 by Michelle Dodd

How the Face Changes With Age: Skin, Fat and Bone Explained

Facial ageing is a complex process influenced by changes beneath the surface of the skin. While fine lines and wrinkles are often the most visible signs, ageing also involves gradual changes to skin quality, underlying fat, and facial bone structure. These factors interact differently in each individual, which is why facial ageing looks unique from person to person.

Understanding how the face changes over time helps explain why assessment and a personalised approach are essential in aesthetic medicine.

Changes in Skin Over Time

As we age, the skin undergoes several natural changes. Collagen and elastin production gradually decreases, leading to reduced firmness and elasticity. Skin may also become thinner, drier, and less resilient due to changes in hydration levels and reduced barrier function. The under-eye area is one of the first areas to show visible fine lines and wrinkles as it is the thinnest skin on the face.

Environmental factors such as sun exposure, lifestyle habits, and genetics can further influence how these changes appear. For some individuals, skin texture and hydration are the primary concerns, while for others, structural changes play a larger role.

The Role of Fat in Facial Ageing

Facial fat provides softness, contour, and support to the overlying skin. With age, fat pads can reduce in volume, shift position, or redistribute unevenly across the face. This may contribute to changes such as hollowing, loss of mid-face cheek fullness, or altered facial proportions.

These changes are not uniform and can vary significantly depending on facial anatomy, genetics, and ageing patterns. This is why volume-related concerns are best assessed as part of a broader facial evaluation rather than in isolation.

Bone Structure and Its Impact on Facial Shape

Facial bones also change over time. Subtle bone resorption can occur in areas such as the jaw, cheeks, and eye sockets, affecting the overall framework that supports the skin and soft tissues. As structural support decreases, the face may appear less defined or more fatigued, even when the skin itself remains relatively healthy.

Bone-related changes are often overlooked but play a significant role in how ageing presents across different areas of the face.

Why Facial Ageing Looks Different for Everyone

No two faces age in the same way. Variations in anatomy, genetics, lifestyle factors, and skin health all influence how ageing changes appear. Some individuals notice fine lines early, while others experience changes in facial shape or skin quality first.

Because of this variability, aesthetic concerns cannot be accurately assessed based on age alone. A comprehensive facial assessment considers skin, fat, and bone together, rather than focusing on a single feature.

The Importance of Individual Assessment

In aesthetic medicine, understanding facial ageing requires careful evaluation of both surface and underlying structures. A personalised consultation allows time to assess facial anatomy, discuss concerns, and consider individual ageing patterns.

In some cases, additional assessment tools such as aesthetic ultrasound may be used to support anatomical understanding and inform clinical decision-making. This approach prioritises safety, precision, and evidence-based care.

When to Seek Professional Advice

Many people seek professional advice when they notice changes in skin texture, facial fullness, or overall facial balance. A consultation with a qualified health professional provides an opportunity to explore these concerns in a clinical, educational setting, without pressure to proceed with treatment.

Understanding how the face changes over time empowers patients to make informed decisions aligned with their individual goals and circumstances.

Frequently Asked Questions

What causes changes in facial appearance over time?

Facial appearance changes due to a combination of factors, including skin quality changes, volume shifts, bone resorption, and repetitive facial movement. These changes occur gradually and affect each person differently.

Is facial ageing the same for everyone?

No. Facial ageing varies depending on genetics, lifestyle, sun exposure, skin type, and individual anatomy. This is why personalised assessment is an important first step before considering any aesthetic care.

Can aesthetic consultations help identify these changes?

Yes. A consultation allows for assessment of facial structure, skin quality, and ageing patterns. This helps identify contributing factors and supports informed discussion about appropriate options.

Do aesthetic consultations involve treatment?

Not necessarily. Consultations are designed to be educational and assessment-focused. Treatment may be proceed if you are deemed appropriate, but there is no obligation to proceed.

Why is a conservative approach recommended in aesthetic care?

A conservative approach prioritises facial balance, safety, and long-term outcomes. Subtle, well-considered care aims to support natural appearance rather than overcorrection.

How does ultrasound support facial assessment?

In selected cases, ultrasound technology may be used to visualise underlying facial structures. This can support anatomical understanding, enhance safety considerations, and assist with treatment planning where appropriate.

What happens to the jaw bone when we age?

Posted on April 18, 2023February 9, 2026 by Michelle Dodd

As we age, it’s natural for bones to lose density and strength — a process called bone resorption. Bone resorption occurs when old bone is broken down by cells called osteoclasts, followed by the formation of new bone by osteoblasts. Over time, the balance shifts: bone resorption outpaces bone formation, leading to a gradual loss of bone mass and strength. The jaw bone (mandible) is not exempt from this process.

How Bone Changes Affect Facial Structure

Research comparing CT scans of young and aged skulls shows that as we age:

The eye sockets widen and lengthen
The nose, brow, and upper jaw decrease in angles
The lower jaw shortens in both length and height

These changes mean the jaw gradually transforms from an “L” shape at the jaw angle into a more vertical, italic-like shape. This affects the overlying facial tissues — skin, muscles, and fat pads — causing hollowing and sagging over time.

Age and Gender Differences in Jaw Bone Changes

Studies analysing skulls from people aged 20–40, 31–64, and over 65 found:

Bone changes occur in both men and women
Women may experience noticeable jaw bone changes earlier, from young to middle age, while men tend to show similar changes later in life

Understanding these natural changes can help explain why facial volume loss, hollowing under the cheeks, and sagging around the jawline occur with age.

Why This Matters for Facial Aesthetic Treatments

Changes in the jaw bone affect the support for facial soft tissue. Recognising the underlying structural changes is critical when planning treatments such as:

Using an evidence-based, consultation-led approach ensures any treatments are personalised, focus on safety, and aligned with your facial anatomy.

Frequently Asked Questions

What happens to the jaw bone as we age?

As we age, the jaw bone naturally loses density and height due to bone resorption. This affects the support for overlying facial tissues, leading to hollowing around the cheeks, jawline, and under the eyes.

Does jaw bone aging affect everyone the same way?

Bone changes occur in both men and women, but women often experience noticeable changes earlier, from young to middle age. Men tend to show similar changes at a later stage.

How does jaw bone aging affect the appearance of my face?

Jaw bone changes reduce support for skin, muscle, and fat pads. This can result in visible hollowing, sagging, and changes in facial contours over time.

Can facial aesthetic treatments help with jaw bone changes?

Bone loss itself cannot be reversed non-surgically. A consultation to discuss volume loss treatments ensures treatments are personalised.

Why is a consultation important before treatment?

Why is a consultation important before treatment?

What is the role of ultrasound in facial consultations?

Ultrasound can be used to visualise underlying structures such as fat pads and muscles, helping plan safe and effective treatment. This is particularly useful for patients concerned about volume loss or hollowing.

4 Causes of Under-Eye Dark Circles and Treatment Options

Posted on April 18, 2023April 3, 2026 by Michelle Dodd

Dark circles under the eye area, including the tear troughs, are a common concern and can be influenced by a range of anatomical and skin-related factors. Importantly, not all dark circles are caused by the same underlying issue, which is why a thorough assessment is essential before discussing potential management options.

Research into the causes of under-eye dark circles suggests that one or more contributing factors may be present at the same time. Understanding these factors helps guide appropriate consultation, education, and treatment planning where suitable.

A published clinical review identified four primary contributors to the appearance of dark circles under the eyes.

1. Hyperpigmentation

Hyperpigmentation refers to increased melanin in the skin beneath the eyes, which can create the appearance of darkening. This effect may be more noticeable when pigmentation occurs over prominent or bulging orbital fat pads, leading to increased shadowing.

Individuals with Fitzpatrick skin types IV, V, and VI are more commonly affected by pigmentation-related dark circles. In these cases, skin tone and pigment distribution play a significant role in overall appearance.

Management approaches for pigmentation concerns are discussed during consultation and depend on individual skin type, history, and suitability.

2. Thin or Translucent Under-Eye Skin

The skin beneath the eyes is naturally thinner than other areas of the face. When this skin becomes particularly thin or translucent, underlying vascular structures may become more visible, contributing to a darker appearance.

These vascular structures may include vessels within the subcutaneous tissue or the orbicularis oculi muscle. In some individuals, this anatomical feature is genetic, while in others it may become more apparent with age.

A consultation allows for assessment of skin thickness, vascular visibility, and contributing anatomical factors.

3. Skin Laxity and Shadowing

Ageing, sun exposure, and collagen breakdown can lead to reduced skin elasticity and firmness. As the skin becomes looser, shadowing beneath the eyes may increase, giving the appearance of dark circles even when pigment or vascular changes are minimal.

Assessment of skin quality and laxity forms part of a comprehensive facial evaluation, particularly when under-eye concerns are present.

4. Volume Changes and Tear Trough Hollowing

Changes in facial volume over time can contribute to hollowness beneath the eyes, commonly referred to as a tear trough. This may be influenced by subcutaneous fat loss in the cheeks, skin thinning, and ligamentous changes associated with ageing.

In some cases, displacement or prominence of orbital fat pads can further accentuate shadowing and contrast in the under-eye area. These volume-related changes are typically assessed as part of a broader facial volume and ageing consultation.

Why Assessment Matters

Because under-eye dark circles can result from multiple overlapping factors, management is rarely one-dimensional. A personalised consultation allows for detailed assessment of skin quality, anatomy, pigmentation, volume changes, and individual concerns.

This assessment-based approach supports informed discussion about suitability, expectations, and appropriate options, rather than applying a one-size-fits-all solution.

Reference

Ranu, H., Thng, S., Goh, B., & Burger, A. (2009). Periorbital hyperpigmentation in Asians: An epidemiologic study and proposed classification.
DOI: 10.1111/j.1524-4725.2009.01213.x

Frequently Asked Questions

What causes dark circles under the eyes?

Dark circles can be caused by pigmentation, thin skin, skin laxity, or changes in facial volume. Often, multiple factors are involved simultaneously.

Can all dark circles be treated the same way?

No. Because causes vary, a personalised consultation is important to identify the contributing factors before discussing suitable options

Does age affect under-eye dark circles?

Yes. Age-related changes in skin thickness, elasticity, and facial volume can contribute to the appearance of dark circles over time.

How does an assessment by a Registered Nurse help?

An experienced assessment evaluates skin, anatomy, and volume to guide safe and personalised discussion of potential treatment approaches.