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2026.02.21
Causes and Treatment of Lumpiness and Sagging of the Side of the Mouth｜What is Jowl Fat?
As a plastic surgeon certified by the Japanese Society of Plastic and Reconstructive Surgery, I have been involved in many cases of trauma, reconstruction, and congenital diseases, and have cultivated precise techniques and a deep understanding of anatomy. He entered the field of cosmetic surgery out of a desire to bring the power of cosmetics to his patients, as a change in one's appearance can also make one's mind more positive. Her specialties include general treatment of the eye area, injections, and sagging skin. I provide treatments that focus on beauty with the medical stance of "sincerely addressing the ideals of the patient.
Hello!
Designing natural beauty with trust.
I am Masataka Fujihashi, a board-certified plastic surgeon.
I'm concerned about the leanness next to my mouth."
This is one of the most common consultations in contouring counseling.
The face line is well-defined, but only the sides of the corners of the mouth appear heavy.
Looking tired and old - there is more than one cause for this.
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Fat called jowl fat
A mass of fat present on the outer to lower corners of the mouth.
It can develop even in younger people, causing the mouth to appear faltering even when stationary.
For fat predominance, jowl fat liposuction is effective.
However, stand-alone treatment is generally not recommended.
If fat is reduced, there will be excess skin.
If the supporting structure is not simultaneously put in place, the appearance of aging may be reinforced.
Especially in the 30s and older, re-fixation with a combined thread lift is almost mandatory.
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Another problem: sagging skin.
After one's thirties, the main cause is often a decrease in skin elasticity rather than fat itself.
Collagen loss, loosening of supporting ligaments, weakening of facial muscles.
When these combine, the same amount of fat appears droopy.
Performing liposuction alone on this type risks accentuating the aging process rather than the other way around.
Determining the cause is everything.
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Structure called modaiolus
On the outer corners of the mouth is a muscular intersection called the modaiolus.
This is a muscular structure, not fat.
Therefore, it cannot "take".
In cases where shadows are caused by muscle volume and positioning, the treatment plan is quite different.
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Approach to Treatment
Jowl fat liposuction is effective for fat predominance in younger patients.
However, stand-alone treatment is generally not recommended.
At the same time, it is important to rebuild support with a thread lift. We believe this is especially essential for patients in their 30s and older.
If skin laxity is advanced, a thread lift alone or a facelift may be indicated.
In cases of strong laxity when liposuction is performed, a combination of radiofrequency such as FaceTite or Quantum is effective.
Promotes subcutaneous contraction and reinforces the tightening effect.
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Positioning of RF therapy
When liposuction is performed, combined use of radiofrequency is effective when skin laxity is present.
FaceTite and Quantum are treatments that are inserted subcutaneously to promote contraction from the inside.
Fat loss and tightening can be reinforced at the same time.
On the other hand, Mofius8 uses microneedle RF to approach the dermis to the shallow subcutaneous layer.
Effective for improving skin elasticity and mild tightening.
Can it be placed subcutaneously or irradiated from the superficial layer?
The choice depends on the purpose and the degree of relaxation.
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Perspectives on Nurturing Collagen
For mild to moderate loss of firmness, treatments that stimulate collagen production such as Volnuma, Potenza (diamond tip), and shopping lift are effective.
The most common misunderstanding here is the hyphen.
The main action of HIF is "contraction and lifting" by thermal coagulation to the SMAS layer.
Although collagen restructuring occurs secondarily as a result, its main purpose is tightening, and it is positioned slightly differently from pure “collagen growth therapy.
In other words,
Hyphen = tightening and lifting leaning
Volnuma and RF systems = closer to dermal remodeling
It is not a dramatic change.
However, preventive accumulation will certainly change the amount of sagging in the future.
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■ Summary
The treatment for the sagging of the sides of the mouth depends on whether fat or sagging skin is the main cause of the sagging.
If fat dominance is predominant, suction plus thread lift is used. If skin laxity is the main concern, thread lift or facelift is selected.
FaceTite and Quantum are used for tightening during liposuction, and Mofius 8 is used to improve firmness.
HIF is primarily for tightening purposes through SMAS contraction.
In addition, continued treatment to prevent collagen loss, such as Volnuma, Potenza, and Shopping Lift, will help prevent future sagging.
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【Profile】
Masataka Fujihashi, MD, Plastic Surgeon
Leveraging expertise as a board-certified plastic surgeon, I offer comprehensive facial cosmetic procedures including eyelid and nose surgery, facial liposuction, thread lifts, and hyaluronic acid injections. From incisional surgeries and revision procedures requiring delicate design to minimally invasive injections and lifts with minimal downtime, I strive to provide treatments tailored to each patient's ideal outcome.
We are dedicated to achieving natural results and minimizing downtime, pursuing medical care that leaves you feeling confident in your choice through sincere consultations.
Designing natural beauty with trust.
We cherish that sentiment and apply it to our daily practice.
Read other blog posts ▼
https://biancaclinic.jp/author_cat/fujihashi/
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【Career】
March 2015: Graduated from the School of Medicine, Showa University
April 2015 Showa University Yokohama Northern Hospital Initial Clinical Training
April 2017 Showa University Hospital Department of Plastic Surgery
October 2017 Maebashi Red Cross Hospital Plastic Surgery / Cosmetic Surgery
April 2019 Nishio Municipal Hospital Plastic Surgery Department
April 2020 Showa University Fujigaoka Hospital Plastic Surgery Department
November 2020 Ota Nishinouchi Hospital Plastic Surgery / Cosmetic Surgery
July 2022 Tokyo Rosai Hospital Plastic Surgery / Cosmetic Surgery Department Head
July 2022: R.O.clinic (Part-time), Kusano Taro Clinic (Part-time)
April 2024 Deputy Director, Ginza TA Clinic
November 2025 BIANCA CLINIC
【Professional Affiliations and Qualifications】
Japanese Society of Plastic and Reconstructive Surgery Board-Certified Plastic Surgeon
Member of the Japanese Society of Aesthetic Plastic Surgery (JSAPS)
Member of the Japanese Society of Aesthetic Surgery (JSAS)
