We’ve all been there: sticking out our chin and pressing our tongue against the roof of our mouth in pictures. Popping the occasional collar. It’s a stubborn problem, that double chin, one that’s un-suck-in-able, un-cover-up-able, and un-Instagram-filter-able. But everyone deals with it eventually. “Your skin begins to thin in your 20s, and then you start losing bone, fat, and muscle in your jaw around age 50—and these changes to your facial structure make your jawline sag like a loose blouse on a wire hanger,” says Jeannette Graf, a dermatologist in New York City, who has no problem telling it like it is. On top of that, your jaw is one of the three areas on your body that “gravity is working against all the time,” says Amy Wechsler, a dermatologist in New York City. (The second and third: boobs.) Until recently, the only procedure that could do a damn thing for jowls was a face-lift. But now there are noninvasive ways to get rid of a paunchy chin. Give her a syringe and a doctor can reshape your jawline. Says Ranella Hirsch, a dermatologist in Boston: “It’s endlessly gratifying.”
THE FILLER UP
You probably think of filler as something for wrinkles. You may even have a few cc’s in your wrinkles right now. But in the jaw, dermatologists use filler very differently. Remember how we told you that the jawbone shrinks, contributing to sagging? “We use stiff fillers, like Radiesse and Restylane, to add structure back to the jaw—like using poles to stretch a tennis net taut,” says Ava Shamban, a dermatologist in Los Angeles. “First, I inject the parts of the jaw that are under the chin and ears, where the mandible bone has shrunk. If that’s not enough support to lift the entire jaw, I’ll inject all the way along the jawline.” The main side effect is a small chance of bruising. This approach isn’t for everyone, though: “If you’ve got a lot of laxity, fillers aren’t going to lift your jaw,” says Hirsch. But for the right patient (with mild to moderate sagging, between the age of 40 and the mid-70s), “it’s very effective at lifting and smoothing the jaw in a natural way,” says Ellen Marmur, a dermatologist in New York City, who is wrapping up a yearlong study on the effects of filler in the jaw.
THE JOWL MELTER
The sun, smoking, genetics—these are the main causes of aging in the jaw and, you know, everywhere else. But there’s also a more surprising source of sagging: “Just as gravity pulls down on your jaw over time, so can a pocket of fat under your chin,” says Graf. “Kybella is an injectable, synthetic form of the fat dissolver deoxycholic acid, which exists naturally in your body.” It breaks down fat cells so they can be flushed out of the body by your circulatory and lymphatic systems. It’ll get rid of a double chin, or what Shamban calls a “jeck,” and as a secondary benefit will tighten tissue, which could help prevent sagging in the long run. “Longer-term results can be excellent, but there’s a period of swelling for one to two weeks, so it’s best to get it in the winter, when you can cover up,” says Hirsch.
THE MUSCLE RELAXER
If you’re not a Bravo enthusiast—and that’s cool, you probably do other things, like read books—Google “Bethenny Frankel jawline before and after.” And click, bam, proof that you can go from having a square jaw to one that’s shaped like a V. “You can narrow the lower half of your face a couple of millimeters by relaxing the masseter muscle—the one at the edge of your jaw—with a botulinum toxin, like Botox or Dysport,” says Marmur. It’s especially useful for teeth grinders, whose jaw muscles bulk up over time; relaxing the muscles also relieves chronic headaches caused by grinding. And it’s got one more happy side effect: “When you smile, your skin should move back and naturally crease a little. But if the masseter muscle is too big, it adds resistance that makes the skin wrinkle around your jaw,” says Doris Day, a dermatologist in New York City. “Just relaxing that muscle can smooth the jaw spectacularly.”
THE SKIN TIGHTENER
Radio frequency is an expensive procedure that goes by fancier names, too, like Thermage and EndyMed. It heats up deep layers of skin, causing controlled damage that stimulates new collagen and firms the skin. Some dermatologists start patients in their 30s on it with the goal of mitigating aging down the road. Others swear by it for tightening sagging tissue along the jaw. Many who use it do so in conjunction with fillers, though. “If a face-lift is a home run for lifting the jaw, radio frequency is like getting to second base, and sometimes that’s enough for patients to stop obsessing over that area,” says Wechsler. “But it doesn’t work well for smokers, sun worshippers, or yo-yo dieters, because all those things break down new collagen in the skin.” And sometimes even nonsmoking vampires won’t create enough collagen to be happy with the results: “A concern is it doesn’t work optimally for all patients, and it can be difficult to know who’s going to respond best,” says Hirsch.
THE STRING THEORY
A new procedure called the Silhouette InstaLift is not for the squeamish, so consider yourself warned. “You take a self-dissolving surgical-grade thread with a long needle on both ends, make three dots along the jaw and chin, and thread under the skin to tighten it,” says Marmur. That thread has little cones attached to it that hook onto connective tissue right below the dermis (and also dissolve). “You push the skin over it, and you hear them clicking into place, and you get some lift of the jaw and neck,” says Shamban. The effects can last about 6 to 18 months. “But there’s a real artistry to doing it, so you’ve got to go to someone who knows what she’s doing,” says Marmur. And some of the dermatologists we spoke with are waiting to be convinced it’s worth it to jump on board.