According to the American Society for Aesthetic Plastic Surgery, or ASAPS, many doctors consider sagging jowls to be among the top facial features that contribute to an aging look, and many women “of a certain age” agree. Droopy jowls serve up a one-two punch to the face as they blur a youthful, sharply defined jaw line and cause the face to look wider and more rectangular. ASAPS members feel that this is the look of an older person.

So, how can you get rid of jowls? Can you do it through jowls exercise?

In a word, no.

Sagging jowls, as well as droopiness in the rest of the lower face, results from a reduction in skin elasticity, a loss of volume under the skin and the effects of gravity. No amount of jowls exercise can change any of those factors.

An ASAPS news release dated this past April discusses the fact that there are a variety of ways to address a jowly look during a facelift. In the words of Charles H. Thorne, a plastic surgeon practicing in Manhattan, the topic is fascinating and potentially controversial among plastic surgeons. Some feel the saggy skin and fat should be pulled up along with the rest of the lower face in a traditional facelift. In fact, this is still the approach favored by many.

Other plastic surgeons believe that droopy fat underneath the skin should be excised or suctioned out. Fat under the skin contributes to a jowly look, not just saggy skin, and research suggests that the fatty tissue atrophies over time. Hence the feeling among many experts that fat in the jowls should be removed.

Dr. Thorne notes that it has been popular in recent years to find techniques to maintain volume under the skin as people age. This is the reason for the enormous popularity of facial fillers and fat transfer procedures. Therefore, a third possible approach to correcting sagging jowls, especially for patients who are not ready to commit to a full face lift, is to fill what Dr. Thorne calls the “pre-jowl area” with fat.

As Dr. Thorne prepared to moderate a panel discussion at the ASAPS annual meeting in late April, other panelist surgeons weighed in on the topic of addressing jowls. In a position no doubt echoed by many, there’s no one correct answer.

What does this mean to you? If you’re concerned about sagging jowls and you’re interested in a facial procedure to address them, be sure to consult at least one board certified plastic surgeon. Ask specific questions about the doctor’s approach to jowl correction. Since so much depends on you—your anatomy, your age, your expectations, your pocketbook and your medical history—you should hear input from the plastic surgeon that addresses you as an individual. And he or she should be able to articulate a philosophy about jowls that makes sense to you.