Facial Skin Tightening Options

I'm open to a face lift or facial plastic surgery but wanted more opinions on a variety of skin tightening options to tighten jowls and skin laxity in the face in general.

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Facelift Information

Ideally a patient should have a consultation in a plastic surgery practice that offers a full range of surgical and non-surgical options so that an appropriate, comprehensive and highly individualized treatment plan can be developed. Surgical or even non-surgical treatment of facial aging changes must be carefully individualized to match each patient's aesthetic needs and desires. In helping a patient to make decisions about plastic surgery for facial rejuvenation, I always examine... more

Michael Law, MD

Raleigh-Durham Plastic Surgeon

ASAPS ASPS

Facelift and LiveFill

Most modern approaches to the face tighten and replace volume. The patient's own tissues placed into hollow areas give the longest lasting, most stable results. LiveFill and fat injection are two techniques that use the patient's own tissues to restore fullness to the face, and are often used in combination with facial tightening procedures.

Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Facial rejuvenation options

How We Age The effects of gravity, sun exposure, intrinsic aging, and the stresses of daily life take their toll on our faces over time. On the surface, the skin accumulates sun damage, leading to age spots, blemishes, and fine lines. Deeper lines and creases develop as the skin loosens and sags. Beneath the skin, the support structures of the face (muscles, ligaments, etc.) loosen, and the soft tissues atrophy so that our face loses volume. This causes a constellation of age-related changes... more

Larry Fan, MD

San Francisco Plastic Surgeon

Tightening sagging facial skin

The answer, simply put, is a facelift. There's lots of hullabaloo about lasers and Thermage tightening the layers of the face, but in the absence of real controlled and peer-reviewed data (not provided by the manufacturers of the devices) and before and after photographs documenting any longterm results of these methods (and thousands of dollars/ multiple treatments later), the facelift is still the gold standard for lifting and tightening sagging facial skin and soft tissue. more

Jennifer Walden, MD

Austin Plastic Surgeon

ASAPS ASPS

Limited alternatives to surgery, if surgery is indicated

I use the "onion" as a good analagy of how we are put together anatomically. The skin is the outer layer, followed by a layer of fat, and then, a strength layer, fat pads, and neres/muscles/blood supply. Procedures like chemial peels, laser, coblation, are great for tightening the skin, and reversing the signs of premature aging due to sun, cigarette smoke, and environmental oxidants, etc. This will do nothing for lifting the deeper layers that have descended over time as a result... more

Scott E. Kasden, MD

Dallas Plastic Surgeon

ASAPS ASPS

The best way to look good is to treat the tissues below the skin.

Although the skin is sagging and the jowls look unsightly, the best way to correct these problems is to tighten the underlying structures. These structures include fat, muscle and fascia (strong connective tissue that holds it all together) in a structure called the SMAS (submusculoaponeurotic system). There are many different techniques to accomplish this but they all have several key points; 1- Lifting the SMAS to its original position makes for a more natural result. 2- Lifting the SMAS... more

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Sagging face - consider fat grafting and surgery

Hello Ms Anne, Lots of great answers to your question here. I wanted to specifically also recommend the option of autologous fat grafting for sagging cheeks. As you have learned by now aging changes related to volume loss are best addressed by volume correction. The BEST way to tighten jowels? Vertical elevation with cranial suspension. Sorry but that is surgery!

Kamran Jafri, MD

New York Facial Plastic Surgeon

Thermage:The Best Way to Tighten Sagging Facial Skin.

By far, the best way to tighten sagging facial skin without surgery or downtime is Thermage. Thermage uses radiowaves to tighten the collagen in the deep layers of the skin, and is very useful to clean up jowls and a loose jaw line. Thermage has been getting mixed reviews, and in fact on the REALSELF.COM website, only 35% of patients felt that Thermage was "worth it". However, do not let this discourage you from exploring this very useful technique. Dissatisfied Thermage... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

The Essential Truths of Facial Rejuvenation

There are several essential truths that must be stated in order to fully answer this question completely. There is an old saying that states: "Small surgery, small results." With rare exception, this continues to ring true. This also applies to treatments in general. A patient and a procedure must match each other in two key ways: A patient's anatomy must be appropriate for the proposed surgery, because surgeries are based on anatomy. A patient's expectations must be... more

Richard W. Westreich, MD

Manhattan Facial Plastic Surgeon

Fill the face with volume, tighten the skin with Fraxel repair

Sagging facial skin results from the loss of volume from the face, and the aging of the superficial skin. Traditionally surgeons correcting the problem pulled the sagging tissue and cut away the excess. You can tell who those patients are when you see them walking down Rodeo Drive in Beverly Hills, Park Avenue in Manhattan, and Collins Drive in Miami. Natural results can be obtained today by restoring volume to the face, and then by treating the face and neck with Fraxel repair. Fraxel... more

Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon

The most effective and best way to get rid of jowls is...

The most effective and best way to get rid of jowls is with surgery. My favored procedure is a mini face-lift called an S lift. This procedure involves incision lines that are hidden behind the ear and thus create no visible scarring. The downtime is shorter than a traditional face-lift (usually only 4 to 5 days), and the procedure can be performed under local anesthesia. For those with less advanced jowl drooping (usually people in the forties), I perform an endoscopic face-lift... more

Andrew Jacono, MD

New York Facial Plastic Surgeon

A facelift is still the best way to tighten jowls and skin laxity in the face

The aging process is composed of not only skin relaxation but also displacement of the underlying tissues like muscle and fat as well as bony reabsorption. If you have minimal lines around the eyes or forehead Botox or other fillers will improve these issues. Deflation of the cheek area and jaw line may also be addressed with fillers. It all depends on your state in the aging process and your expectations post treatment. I would recommend speaking with a board certified plastic surgeon who... more

Vivian Hernandez, MD

Boca Raton Facial Plastic Surgeon

ASAPS

Well-rounded approach to skin tightening

With every patient that comes into my practice, it is important to evaluate three key components of aging: Skin Gravitational changes Volume loss If your problem is sun-spotted, wrinkled skin with mild laxity, then skin resurfacing with either laser or chemical peel should be considered. If the issue is gravity, then the answer is surgery to restore the skin & underlying structures to their former position. The aggressiveness of the facelift (from... more

Yael Halaas, MD

Manhattan Facial Plastic Surgeon

The key to facial rejuvenation is first, proper analysis...

The key to facial rejuvenation is first, proper analysis of the problem, and then to design a treatment plan to provide the patient with a durable, safe result. The fundamental issue with jowling is that it makes the jawline look too square, and a youthful jawline is shaped more like a triangle. While some lasers can tighten the skin, and fillers can hide the jowls a bit, the underlying issue of relaxation of the skin AND the underlying tissues will not be durably addressed with these... more

Shahram Salemy, MD

Seattle Plastic Surgeon

ASPS

Treatment of the aging face and sagging skin

A facelift tightens aging facial skin but it doesn't improve the skin quality. Bad skin quality can ruin a good facelift result and should also be treated. Skin with lots of blemishes and wrinkles is bad quality skin and can usually be treated with skin care programs, chemical peels or laser therapy.

Daryl K. Hoffman, MD

Los Gatos Plastic Surgeon

ASPS

Choosing between different types of lifts and fillers...

Choosing between different types of lifts and fillers really depends on the quality of the skin, how far the individual is willing to go, what result they are looking for and how permanent they wish the result to be. Dermal fillers give an instant result for the typical wrinkles between the nose and the corners of your mouth, but needs repeating every 6 months. You can also get a neck and eyebrow lift with only Botox. Threadlifts are great for a moderate amount of excess skin, with not too... more

Barbara Jemec, MD

London Plastic Surgeon

Face Lift, Mini Face Lift, The Palmer Celebrity Face Lift, Beverly Hills Face Lift

I know it's sounds tempting for a laser or similar treatment to tighten the Jowls and skin of the face but the reality with the current technology is as follows: Only cutting and removing skin with some version of a Face Lift is likely to tighten the skin more than a few mm's, with typical Face Lifts removing 2 inches or more excess skin. Lasers and other non Face Lift therapies would not be able to Cut, lift, trim and re-suture the SMAS layer Face Lifts can... more

Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon

Facelift vs non-invasive methods of skin tightening

I have experience with many forms of skin tightening. Frequently they work to some extent. The technology i favor the most is radio frequency (RF). This will tighten tissue. Having said this, it doesn't touch the ability of a face lift to change your appearance and give a more youthful look. All the best, Tal Raine MD FACS

Talmage J. Raine, MD

Chicago Plastic Surgeon

ASAPS ASPS

Facelift, Liposuction, Thermal Skin Tightening All Options For Facial Rejuvention

The question you pose is quite broad. There are many options for skin tightening including laser resurfacing, facelift surgery, thermal skin tightening, liposuction, and several others. Unfortunately one size does not fit all and meeting with a facial plastic surgeon who performs a myriad of different techniques will provide you with the best evaluation of your options.

D.J. Verret, MD

Dallas Facial Plastic Surgeon

Facelift and Tightening Options

That is a rather broad question. For the most part, facelifts address 3 main cosmetic areas: midfacial fat sagging, jowls, and excess neck skin. To best evaluate your surgical options, an in person consult would be indicated.

Jeffrey S. Epstein, MD

Miami Facial Plastic Surgeon

Non-Facelift Facial Skin Tightening

Depending on the extent of facial skin looseness and sagging, there is no substitute for a well performed Facelift. But - there are several options that may come close. The area of non-surgical skin tightening is the hottest area in Plastic Surgery and billions of dollars are spent on research, production and marketing of multiple devices which claim to accomplish this goal. All is based on the propensity of injured skin to shrink. The question is how can we get the maximal skin shrinkage... more

Peter A. Aldea, MD

Memphis Plastic Surgeon

ASPS

Jowl Elevation and Skin Tightening: Facelift

As enticing as non-surgical elevation of jowls may sound, it has yet to become reality with any treatment other than Facelift. Treatments such as Thermage have made great promises with very mixed results and many dissatisfied patients. Likewise, although skin laxity can be improved with fractionated laser resurfacing, it will not reproduce the same result as Facelift. Given your description of skin laxity and jowls, I would recommend Facelift with concomitant fractionated CO2 laser... more

Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

Face Lifts are the gold standard for facial skin tightening

There are some patients who will definitely benefit from a surgical facelift to address lax tissues and skin that accompanies aging. However, some patients with mild signs of aging and good skin elasticity may benefit from laser 'skin tightening' treatments alone, such as with ReFirme treatments of Titan treatments. Realize that these non surgical treatments deliver gradual reasults and that you should be patient with them. If you desire more immediate results, I would recommend you undergo... more

Sanjay Grover MD

Orange County Plastic Surgeon

ASAPS ASPS

Facial Skin Tightening

Ms Anne The gold standard treatment for jowls and skin laxity was the face-lift. Now there are several other treatments that can give very good rejuvenative results with less invasive procedures, such as: Micro-liposuction of jowl fat Skin tightening with laser resurfacing Chemical peels Fractionated lasers Fillers to replace and lift soft tissue volume in the face I recommend that you consult with a board certified plastic surgeon who is comfortable with both... more

Daniel Reichner, MD

Newport Beach Plastic Surgeon

ASPS

Sometimes surgery isn't the answer

As we age, we need to address both the quality of the skin (thinning, looseness) and the loss of volume in the face that causes the skin and face (especially the cheeks and jowls) to droop. Is isn't that there is one best treatment, it's really a multi-pronged approach. It's usually a good idea that before considering surgical approaches you try some of the non-surgical treaetments. As we age, we lose volume in our faces and we can look hollow and saggy. Dermal fillers, like Restylane,... more