Jawline sagging in Daegu — the order for choosing lifting devices and boosters
A jawline blurs for more than one reason. Thinning skin, more fat under the jaw, and hollow cheeks that make the lower face look as if it has dropped are different causes, and each cause calls for a different first treatment. Here is why we settle the order before the device name.
The short answer
For jawline sagging we divide the cause into three and set the order from that. If deeper layers have dropped and the contour has collapsed, we consider RF or focused ultrasound lifting devices first; if the skin itself is thin and has lost firmness, collagen boosters first; if hollow cheeks or temples make the lower face look saggy, treatment that addresses volume first. Devices that tighten with heat do not create volume and can make a hollow face look more hollow. Ultrasound data also show thinner skin and thicker superficial fat in sagging areas under the jaw, so we look at thickness and fat first.
Three reasons a jawline blurs
| Cause | What it looks like | Consider first |
|---|---|---|
| Sagging of deeper layers | Tissue drops below the jawline and the contour line breaks | Lifting devices — Density · XERF · Oligio Kiss |
| Thinning skin and loss of firmness | Skin wrinkles limply and slackens | Collagen boosters — CaHA · GOURI and others |
| Volume loss in cheeks or temples | The upper face hollows, so the lower face looks relatively saggy | Treatment that addresses volume — fillers · CaHA |
Facial layer thickness varies greatly between people. In a 3D study of 30 embalmed cadavers, skin measured 2.1 ± 0.4 mm, but superficial fat measured 5.2 ± 1.9 mm, with large individual variation. In an ultrasound review of 200 people, sagging areas under the jaw had thinner skin and thicker superficial fat. The same “jawline sagging” can mean quite different conditions in the layers that heat will reach.
When a device comes first
A face where deeper layers have dropped and the contour line has broken is not lifted by injections, so a device comes first. Miso Clinic’s three devices work in different ways.
| Device | Method | The face it brings to mind first (clinical judgement) |
|---|---|---|
| Density | Sequential monopolar → bipolar RF | Thicker skin and deeper sagging |
| XERF | Monopolar RF, 6.78 MHz + 2 MHz | No anaesthesia burden and same-day return matter |
| Oligio Kiss | RF + focused ultrasound | Loss of skin firmness and deep sagging together |
No study has compared the three devices directly under the same conditions. A 2026 systematic review also recorded that no direct comparison between RF devices was found. The table above is not a study result but clinical judgement starting from the condition of the face.
Device results are judged two to three months later, not the next day. The tightness right after treatment is instant collagen contraction and swelling, and settles soon.
When injections come first
If thin, weak skin is the main cause, we address the material before adding heat. The reason for this order is that using a device alone on thin skin leaves too little material to work with.
- Loss of firmness + gentle hollowing of the cheeks — CaHA (DCLASSY · Radiesse). Gives immediate volume and collagen stimulation together, but cannot be dissolved to reverse it, so it is placed conservatively.
- Texture and density have broken down — GOURI, Rejuran or the hADM class. These do not lift sagging.
- Using CaHA for the jawline contour itself — the US FDA approved CaHA for jawline contour in 2022, but it is outside the Korean approval.
Treating a face with hollow cheeks or temples only with heat tightening can make it look more hollow. In such cases we address volume first and put the device later.
The order when both are needed
- Step 1Separate the causesWe look sitting and lying down, and with the lighting from different directions, to weigh sagging, thickness and hollowing.
- Step 2One treatment for the biggest causeStart with a single treatment matched to the largest cause. Doing several at once makes it impossible to tell what worked.
- Step 3Judge at two to three monthsWhether device or collagen booster, review when the change has settled.
- Step 4Plan the next treatmentDecide the second treatment and the interval from the causes that remain.
We could not find any randomised comparison showing that combining a device and a booster beats either alone. The reason to consider combining is that the causes are mixed.
Summary
What is established
- Causes of jawline sagging divide into deep sagging, thinning skin and volume loss
- Facial superficial fat thickness varies greatly between people (5.2 ± 1.9 mm); sagging areas under the jaw have thinner skin and thicker superficial fat (ultrasound, 200 people)
- CaHA’s jawline contour indication is a 2022 FDA approval — not within the Korean approval
What we could not find
- A direct comparison of Density, XERF and Oligio Kiss
- A randomised comparison showing device + booster beats either alone
- Long-term device-specific data evaluating the jawline alone
Jawline sagging in Daegu: frequently asked questions
For jawline sagging, which comes first, a lifting device or a booster?
The cause decides. If deeper layers have dropped, a device; if the skin is thin and weak, a collagen booster; if hollow cheeks make the lower face look saggy, treatment that addresses volume is considered first.
Which is best for the jawline: Density, XERF or Oligio Kiss?
No study has compared the three devices directly, so there is no basis for naming the best one. We decide which device to consider first from skin thickness, depth of sagging, whether loss of firmness is also present, and the anaesthesia burden.
Does losing weight change the result of jawline lifting?
Radiofrequency lifting is not a fat-reduction treatment, and we could not find a study that measured the effect of weight change on results. The thickness of superficial fat does change the conditions for delivering heat, though, so we plan from your current state at consultation.
When is the result of jawline lifting judged?
Two to three months after treatment. The tightness right afterwards is instant collagen contraction and swelling and settles soon; the lasting change is remodelling over weeks to months.
Will filler or Radiesse in the jawline lift it?
Treatment that addresses volume can fill hollow areas and reduce the saggy look, but it does not pull sagging tissue upward. The jawline contour indication for CaHA is a US FDA approval and is outside the Korean approval.
Read next
- Why we look at skin thickness and facial fat when choosing a lifting treatment
- Oligio Kiss, Density or XERF in Daegu — choosing by skin thickness
- DCLASSY · Radiesse in Daegu — who is a CaHA collagen booster right for?
- Facial sagging in Daegu — starting with which layer the treatment works on
- “Should I have a booster, or a lifting treatment?”
Product pages
Device references: Density · XERF · Oligio Kiss / injectables compared: Collagen boosters compared
Who wrote this
Written and reviewed by Lee Chi-Hak, MD, medical director of Miso Clinic in Daegu, South Korea. Every study cited above is given together with its design, its size and the limitations the authors themselves recorded, and where we could not find data, we have said that we could not find any.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- Individual variation in facial layer thickness — Lee KW et al., Clinical Anatomy 2021;34(7):1050–1058, PMID 33583088. 3D measurement of 30 embalmed cadavers: skin 2.1 ± 0.4 mm, superficial fat 5.2 ± 1.9 mm.
- Ultrasound of lower-face layers — Kwon SH et al., Dermatologic Surgery 2022;48(5):527–531, PMID 35093961. Retrospective review of 200 people. Sagging areas under the jaw had thinner skin and thicker superficial fat.
- Evidence comparing RF devices — Aesthetic Surgery Journal Open Forum 2026 systematic review (15 studies · 1,230 subjects, one randomised controlled trial). It states explicitly that no direct device-to-device comparison was found.
- CaHA approvals abroad — US FDA, Radiesse Summary of Safety and Effectiveness Data (P050052 and subsequent supplements). Facial wrinkles 2006 · dorsal hand 2015 · jawline contour 2022 · décolleté 2026 (152 subjects · 84-week multicentre randomised trial). Jawline and décolleté are outside the Korean approval.
- Miso Clinic clinical protocols — criteria for indications, design by area, and the explanation and consent process before treatment. The source of the sentences marked “clinical judgement” in this column.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.