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Jowls are caused by: Step 1: fat in our cheeks starts to disappear in our 30s and skin slips down the face toward the jawline, and forward toward our mouth (it starts to accumulate outside the smile lines, which are a natural connection of skin to fascia, and will become the point at which most skin and fat accumulates behind, creating jowls) Step 2: Fat slowly starts to lose its connection points within the cheek and slips downward and forward Step 3: Left alone, that fat weighs on skin thats already starting to lose a lot of its elasticity due to natural aging processes