Alternative Procedure to Tighten Jawline?

What is the best option for tightening the jawline for the very beginning of jowls? I am only 43 and have been told that I am not ready for any type of Facelift; however, I don't like the appearance of my lower face.

I have tried Thermage twice and it has not produced the effect I had hoped for. Thank you

Doctor Answers 35

Is a #Toronto #facelift an option for women and men age 40? It depends...

Thank you for your question as this is often an answer I have to discuss in my practice in downtown Toronto and in Richmond Hill, north Toronto, Ontario.

There is no minimal age for facelift as long as you present the anatomical reasons for such a procedure.  There are shorter and less invasive techniques such as short-scar, skin-only or fat grafting alone or in combination with the skin excision.

Fillers are also a great way to slowly venture into #Toronto #aesthetic plastic surgery.  I have been practicing for 13 years now and commonly teach the filler techniques to other doctors across Canada.  I am a big user of Juvederm Voluma and Volbella for jaw contouring and liquid facelift.  Those new highly-cross-linked products last up to 18 months with no or very minimal downtime.  I must say since I have been using the cannula technique since 2011, bruises are almost never an issue anymore!  

Cost for the procedure(s) and Recovery are factors to consider.

Feel free to read my blog on the Cannula Technique.

I also like Radiesse for the jaw contouring and Perlane, the bigger 'brother' of Restylane.  My only limitation with Radiesse is that it cannot be used closer to the eyes and to the month, yet, it can be combined with the other juvederm and restylane products.

I do discuss the SMAS and facelift technique on my blog:

I hope this helps and it would be our pleasure to meet you at Visage Clinic in Toronto and Richmond Hill.


Best regards, 

Dr. Marc DuPere, Toronto plastic surgeon

Voted TOP plastic surgery Clinic in Toronto for 2013 and 2014

Voted TOP Cosmetic Clinic in Toronto for 2014

Toronto Plastic Surgeon
5.0 out of 5 stars 51 reviews

Alternative procedure to tighten jawline

In my plastic surgery practice and medical spa we offer many non-surgical treatments for aesthetic enhancement. However, without an evaluation, it is impossible to know what is best for you.  Excess skin can really only be treated effectively with surgery, even if the surgery is limited. 

Fillers, like Juvederm Voluma, or even fat grafting can be wonderful for adding volume to hollow areas, but adding volume to jowls could make the lower face appear heavy and make your issue more of a problem.

Look at many, many before and after iamges and do your homework when selecting a surgeon.  Often people who never seem to age have had a little "work" along the way, so there never seems to be a major change, almost a perpetually youthful face. A plastic surgeon with expertise in providing natural results is who you need.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 70 reviews

Treatment for jowls with a mini facelift cam be your best option

To answer this question for you I would really need to see your photos as any advice otherwise would just be a guess. Jowls can be SLIGHTLY improved with SKILLFULLY performed liposuction on SOME people. But in general the safest and most effective to improve the jowl is with a Facelift. I have done facelifts on many people in their early 30's who had significant jowls ( who had already had treatments like liposuction and Thermage etc). The results can be amazing and the patients have been thrilled and wished they had done the procedure even earlier.

Jason B. Diamond, MD
Beverly Hills Facial Plastic Surgeon
3.5 out of 5 stars 9 reviews

40 year old with early jowls

At 40 years old and a touch of jowls, I would agree with the surgeons who have suggested camouflage techniques such as Radiesse.  This often works well, is safe, and does not hinder your ability to do other procedures in the future.  It does not surprise me that you are dissatisfied with Thermage, I don't believe I have ever met a patient who was.  I would encourage you to avoid all of the various machines that claim to provide a facelift without surgery, patients rarely see the promised changes, or even any change at all for that matter.  At your age I encourage you to be conservative.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Alternative procedures to tighten jowl line

In my experience if you are trying to avoid surgery your next step would be to give Fraxel laser treatment a chance on your skin to see if this would tighten it sufficiently to meet your goals. If not, a minimal procedure such as a u-lift incision around the bottom of the ear may be required. In my practice, I am always happy to treat with no incisions if it works. But if it doesn't work we move to more advanced procedures. My personal experience with Thermage was disappointing, though I'm aware many people obtained successful outcomes with it.

Deason Dunagan, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 8 reviews

Different options to tighten the jawline

Patients today have many different options to tighten and recontour the jaw line. Patients may consider a dermal filler that can help camouflage a small amount of sagging along the jawline. Patients may consider a lower face or neck lift to help redraping the tissues of the lower face and clean the edge of the jaw. These techniques are often combined with fat injection to help replace some of the fat that is naturally lost in the aging process. For best results, you should work with a board-certified plastic surgeon who has great deal of experience in lower facelift techniques, dermal fillers, fat grafting, and facial rejuvenation they will be able to assess the and let you know which combination of techniques will help meet your personal goals.

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 68 reviews

Alternative procedures for tightening jawline

Despite the promise of Thermage and other Laser, radiofrequency, IPL devices, etc., I find they rarely deliver what patients expect.

You might consider Mittleman pre-jowl implants, which are a type of chin implant which is flat in the chin, but has a "bump" in the area of transition between chin and jowl ("pre-jowl"). It nicely smooths the line of the jaw.

Another approach is a combination of very light lipo of the cheek combined with filler or fat injection into the "pre-jowl" area.

These procedures do not tighten the skin per se, but they give the jawline a uniform and youthful appearance. You might want to give this a temporary try by injecting Radiesse into the prejowl area. If you don't like the effect, it's OK, one can manually massage and flatten the filler to reduce the effect. If you like the effect, you might want to continue periodically reinjecting Radiesse or trying the Mittleman prejowl implant, or the combo of lipo with fat injection.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 67 reviews

Radiofrequency Tightening May be Your Best Bet

But unfortunately you did not get much help from Thermage. The Refirme system combines laser light plus radiofrequency to tighten skin, but like Thermage the results are highly variable.

Deeper chemical peels can offer some thightening but rarely correct true jowl formation. You may have to wait until you are ready for a mini-facelift

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 224 reviews

Best option is surgery

Most predictable and reproducible option for skin tightening of any kind is surgery.  You may not need extensive surgery especially if the changes are minimal. Each surgery is custom tailored to each patient need.  It is not a bad idea to start early. Thus you never look old.
Beginning of jowls can sometimes be corrected by doing just liposuction. Required skin tightening, if need can be accomplihed by lower facelift. 

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 17 reviews

Facelift alternatives

Tightening the jawline can be accomplished in a number of ways especially under the age of 45.  Finding an experience facial surgeon who can perform a nonsurgical facelift or necklift would improve the jowling significantly.  Alternatively, you can try using a fractionated CO2 laser to tighten the skin somewhat but this will most likely need to be combined with fillers.  Tightening devices, such as radiofrequency and ultrasound tightening, have hit or miss results, but if you have the money, they can provide a good result without much downtime though the likelihood of not getting a result is higher than the first 2 options.  

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.