If you’re reading this, chances are you Googled “does CO2 laser help with jowls.” If that’s the case, you’re in excellent company.
In my practice at Emerge Aesthetics in Bergen County, jowls are one of the most common things my patients ask me about. They usually tap a finger on the side of their face near the jawline. Then they ask if there’s something we can do to firm things up, ideally non-surgically.
I’m Dr. Rochelle Kling, a double board-certified Emergency Medicine physician and the founder of Emerge Aesthetics. Before I dove headfirst into aesthetics, I trained in general surgery. It’s that foundation that I still use today when I’m thinking about treatment recommendations for my patients.
I want to be clear about what CO2 laser can and can’t do when it comes to jowls. I’ll also cover who can expect to see the best results, and when a different procedure might make more sense.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Results may vary.
Does CO2 Laser Help With Jowls? The Honest Answer
Jowls form as a result of a natural loss of collagen and elastin (the proteins that keep your skin firm and springy). Certain fat pads and support structures in the lower face also shift position.
According to the American Academy of Dermatology, women can lose about 30% of the skin’s collagen in the first five years of menopause.
As the support structures in our face lose strength, gravity pulls on these tissues. Our once well-defined jawline begins to soften and sag as a result.
So, back to the question at hand, can CO2 laser help with jowls?
The answer is… sort of.
CO2 laser treatment can improve the appearance of mild to moderate jowls. It tightens loose skin, stimulates collagen production, and improves the texture of the skin along the jawline. It cannot, however, get rid of excess skin or lift significant sagging because it doesn’t address the deeper structures in the face.
Think of CO2 laser as a treatment that acts on the skin (and only the skin), and not the supporting cast underneath.
That said, there is some research to suggest that CO2 lasers can have a positive effect on the appearance of jowls. More on that in a moment.
As is always the case, everyone ages differently. What will be most effective for your concerns can only be determined after an in-person consultation. Keep reading to learn more about whether CO2 lasers might be right for you.
What Research Says About CO2 Laser for Jowls
A study published in the Journal of Clinical and Aesthetic Dermatology looked at a single fractional CO2 laser treatment on the neck. One-month and one-year follow-up scores for horizontal neck lines, jowling, fat deposition, and skin laxity were all significantly lower than pre-treatment values. Every patient in the study showed significant improvement in all four areas.
The authors of the study concluded:
“The results of this study confirm that fractional CO2 neck rejuvenation is an effective treatment option with long-term efficacy for patients who mainly have skin laxity and jowling together with skin surface pigmentation.”
Pay attention to the authors’ use of the phrase “mainly have skin laxity.” CO2 laser treatment will be most effective for jowls that are the result of loose, saggy skin. It’s less effective in cases where sagging fat pads or bone loss are the main culprits. No amount of laser resurfacing is going to lift a fallen fat pad back into place.
When a Facelift May Make More Sense Than CO2 Laser for Jowls
As you can see, CO2 laser treatment can be helpful for improving the appearance of jowls. That’s especially true when saggy, crepey skin is the main issue.
When there’s significant sagging, however, a surgical treatment (like a facelift) is typically the only option that will deliver noticeable results. It works by lifting and repositioning sagging tissue in the lower face.
My patients are almost always somewhere in between. That’s why I frequently recommend combination treatments that may or may not include CO2 laser treatment. There’s no one treatment that does it all!
What Causes Jowls
Jowls can be the result of several different factors. Some can be improved with CO2 laser treatment, and some can’t.
Loss of collagen and elastin. As mentioned above, the collagen and elastin in our skin thin as we age. That leaves the skin lax and more likely to sag and droop, especially along the jawline. CO2 laser treatment can help combat collagen and elastin loss by triggering new collagen production in the skin.
- Sun damage. Overexposure to UV rays over time also leads to collagen loss and poorer quality skin overall. CO2 laser treatment can help improve the overall texture and tone of sun-damaged skin.
- Sagging fat pads. Two fat pads in the face tend to sag downward as we age. They collect along the jawline: the jowl fat pad and the buccal fat pad (located in the cheeks). CO2 laser treatment cannot address sagging fat pads.
- Bone and volume loss. Believe it or not, our bones actually recede as we age, particularly in the midface. This loss of bone (and the volume it provides) essentially removes the support structure our skin rests on. That can result in sagging and laxity in the overlying skin. CO2 laser treatment cannot reverse bone or volume loss.
- Genetics, weight gain or loss, and overall health. Genetics play a role in the aging process and can contribute to more (or less) laxity in the skin. Significant weight gain or loss can also leave the skin lax. That may be difficult to improve with resurfacing treatments like CO2 laser.
Can CO2 Laser Tighten Sagging Skin Around the Jawline?
Fractional CO2 laser treatment is an ablative laser resurfacing procedure. It creates tiny, controlled columns of injury that resurface the skin, starting with the outermost layer (the epidermis). At the same time, it delivers heat energy deeper into the skin (the dermis). That heat tightens existing collagen and stimulates new collagen and elastin production.
Firming and tightening the skin is what the laser does. Lifting the tissue underneath is what it cannot do.
If you’re interested in learning more about fractional CO2 laser treatment, check out our in-depth guide.
What Results Can You Expect From CO2 Lasers for Jowls?
The degree of improvement that fractional CO2 laser treatment offers varies from patient to patient. It depends on a number of factors.
How Much Sagging You Have
Patients with mild to moderate laxity are typically good candidates for fractional CO2 laser treatment. Those with very pronounced sagging may see less-than-stellar results. That’s because the position and overall volume of the skin (as opposed to the quality of the skin) is the issue.
How Deep the Treatment Goes
Laser settings can be adjusted based on the patient’s skin type and aesthetic goals. Deeper treatments tend to provide greater collagen remodeling and tightening, but can also require a longer recovery period. Lighter treatments will have a quicker, easier recovery, but improvement will be less noticeable.
Results are also only as good as the provider administering the treatment.
How Many Sessions You Need
Depending on your aesthetic goals, skin type, and treatment depth, your provider may recommend multiple treatments. These are spaced weeks or months apart for optimal results. For jowls, a series of treatments will often deliver better results than just one deeper treatment.
How Your Skin Heals
Recovery from fractional CO2 laser treatment depends on several factors, including:
- Overall health and biology
- Age
- Skin type
- Adherence to post-treatment care instructions
Generally speaking, you can expect redness, swelling, and flaking for anywhere from a few days to a week after treatment. That downtime depends on the depth of the treatment. For more information on what to expect, check out our guide to the laser skin resurfacing healing process.
Collagen Remodeling Over Time
Results evolve over time. You’ll see improvement in tone and texture within weeks of treatment. Collagen remodeling and tightening continue to build for three to six months after treatment.
How Long Results Last
Fractional CO2 laser treatment for jowls is not a one-and-done type of situation. Results last, but they are not permanent, as the aging process doesn’t stop just because you’ve had laser resurfacing treatment. That said, it’s much easier to maintain your results over the long term than it is to combat new damage down the road. Daily sun protection and consistent use of quality, medical-grade skincare products are a must.
Who Is a Good Candidate for CO2 Laser for Jowls?
Fractional CO2 laser treatment is ideal for patients who:
- Have mild to moderate jowls or laxity (not due to pronounced sagging)
- Would also like to improve fine lines, wrinkles, acne scars, sun damage, or overall skin texture
- Would like to postpone or avoid surgery
- Can adhere to a post-treatment care routine, including strict sun protection
- Have realistic expectations about tightening skin versus lifting tissue
Who Should Avoid Fractional CO2 Laser for Jowls?
As mentioned above, CO2 laser is unlikely to deliver optimal results in patients with pronounced sagging or excess skin. In these cases, I tell my patients during the consultation. It’s always better to be upfront.
Patients with deeper skin tones should proceed with caution with ablative resurfacing treatments like the fractional CO2 laser. That’s due to an increased risk of adverse pigment changes. These patients aren’t automatically disqualified, but the treatment plan and settings will likely need to be adjusted accordingly.
If your laxity extends under the chin or down into the neck, the neck deserves its own plan. Our guide to treatment for loose neck skin covers that region specifically.
Other Treatments for Jowls
Fractional CO2 laser treatment improves skin laxity and skin quality. It can’t address the deeper issues that contribute to the development of jowls. That’s why it’s often incorporated into a comprehensive facial rejuvenation plan alongside other treatments. Here’s a rundown of the other jowl treatments we recommend.
Thread Lift
During a thread lift, dissolvable threads (sutures) are placed beneath the skin. They gently lift and reposition sagging skin (in this case, along the jawline) and secure it in a more youthful-looking position. Thread lifts are an excellent option for patients who need a true “lift” but aren’t ready for surgery. That’s something CO2 laser can’t provide on its own.
Combining thread lifts with fractional CO2 laser treatment is a great way to cover both. Threads lift the lower face and jawline, while the laser improves skin quality and smooths the complexion.
AVAVA Skin Tightening
AVAVA is a non-ablative skin rejuvenation and tightening treatment. It delivers ring-shaped microbeams of laser energy into the dermis. This encourages new collagen and elastin production and tightens sagging skin from within. AVAVA uses Focal Point Technology™ to deliver focused laser energy efficiently. Its ComfortCool™ technology keeps the patient as comfortable as possible during treatment.
Since AVAVA doesn’t remove the top layer of the skin the way CO2 laser does, it’s associated with less downtime and discomfort. It’s also safe and effective in all skin types (Fitzpatrick skin types I through VI). That makes it my treatment of choice in patients with deeper skin tones. Learn more on our AVAVA skin tightening page.
AVAVA can’t provide a true “lift” the way threads or surgery can. Still, it is an excellent option for patients with mild to moderate skin laxity. It’s especially helpful for those with deeper skin tones or limited downtime. As of right now, Emerge Aesthetics is the only verified AVAVA med spa in Bergen County. We’re also one of only two practices offering AVAVA treatments in all of greater New Jersey.
Dermal Fillers and Collagen Biostimulators
Remember the bone and fat loss we discussed? Dermal fillers strategically placed along the cheeks and jawline can restore foundational support. They help lift the overlying skin and soften the crease where jowls form.
Collagen biostimulators work in a complementary way. Sculptra stimulates your body’s collagen production over several months to improve skin texture and restore lost volume. Radiesse also encourages collagen production while helping tighten and firm the skin.
Where lasers can’t rebuild support, these injectables can lay the groundwork.
Combining Treatments
For jowls, my ideal treatment plan typically includes a collagen biostimulator or dermal filler, plus CO2 or AVAVA laser treatment. I sometimes add threads if additional lifting is beneficial, and medical-grade skincare at home rounds it out.
Layering treatments allows each modality to perform within its strengths without pushing any single treatment beyond what it can realistically achieve. The result? Lower face rejuvenation that looks refreshed and balanced, never overdone.
The goal is always to look restored, not different.
Facelift as a Surgical Treatment
While we don’t perform facelifts at Emerge Aesthetics, for advanced jowls and significant excess skin, a facelift remains the gold-standard treatment. No non-surgical option can reposition deep tissues or remove excess skin the way a skilled surgeon can.
As always, my goal is to give you honest guidance about your treatment options. Sometimes that means recommending a treatment we don’t perform at our med spa. This is medicine, not marketing.
Build Your Jawline Plan With a Bergen County Physician
CO2 laser treatment can improve the appearance of mild to moderate jowls. It tightens skin, resurfaces sun damage, and boosts collagen for stronger, firmer skin over time. However, it can’t add volume or physically lift the lower face.
For more advanced jowls caused by fat descent or volume loss, a layered treatment plan works best. Pairing CO2 laser with dermal fillers, collagen biostimulators, or threads can help you get more balanced, natural-looking results.
I perform all laser treatments at our med spa personally using our SmartXide Pro CO2 laser system. I also offer AVAVA laser, another excellent option for stimulating collagen and skin tightening.
Ready to explore your options? Call us at 201-383-5299 to schedule a consultation.
Your skincare is the foundation of every treatment plan I recommend. Start firming your skin at home with my favorite products in the Emerge Skincare Shop. Consistent use of a medical-grade vitamin C serum is one of the best long-term investments you can make for collagen support. Try the Alastin C-Radical Defense Antioxidant Serum.
Stay up to date with the latest specials, discounts, and updates at Emerge Aesthetics by following us on Instagram! For more guides like this one, browse our blog.
Emerge Aesthetics proudly serves patients from New York City. We also serve the Bergen County communities of Glen Rock, Ridgewood, Wyckoff, Franklin Lakes, Paramus, Saddle River, Upper Saddle River, and Ho-Ho-Kus.
About Emerge Aesthetics
Emerge Aesthetics is a physician-led, physician-owned medical spa in Bergen County, New Jersey. Every treatment is performed personally by Dr. Rochelle Kling, a double board-certified Emergency Medicine physician with surgical training who brings surgical-level precision and a deep understanding of anatomy and tissue healing to non-surgical, regenerative aesthetics.
This post is for educational purposes and is not medical advice. Individual results vary, and a consultation determines whether a treatment is right for you. If you take medications or have a medical condition, talk with your physician before starting any new treatment.
Rochelle Kling MD