46 and Am Not Happy with my Jawline and Neck? (photo)

I'm 46 and feel like the last 6 months my face has just kind of fallen. I've seen several plastic surgeons with varying responses; from mesotherapy to a mini lift (where only the skin is lifted) to a full mid and lower facelift including neck. I know best results come from full facelifts but... I live in Europe where Aptos or thread lifting seems pretty popular. Is it safe? How long will the results last? Why did it fall out of favor in the US?

Doctor Answers 2

Option to Improve Jawline and Neck

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With a mini-lift, only the lower face -- from cheek to chin -- is lifted, which effectively eliminates jowls and redefines the cheekbones. As with a face-lift, the mini-lift is often accompanied by a neck lift, which removes fat from below the chin and tightens the neck's platysma muscles, all through a tiny incision under the chin. The best candidates for the mini-lift are those who are unhappy with the contour of their lower face and neck, and whose skin has good resiliency. It's also an ideal procedure for a patient who is nervous about going all the way with a major overhaul.


You may also be a candidate for a Threadlift. A non-surgical face-lift that is minimally invasive and addresses signs of aging in the face, including droopiness of the skin of the brow, cheeks, jowls, and neck without incisions or scars. Threads are inserted painlessly under the skin to lift and contour the tissues, providing an immediate tightening. The procedure can be performed using local anesthesia, and most patients can return to normal activities the next day.

Thermage® is now a safe, non-invasive, radiofrequency (RF) cosmetic procedure that’s clinically proven to help smooth, tighten and contour skin for an overall younger looking appearance. The treatment delivers natural looking results with little to no downtime —on all skin colors, on and off the face, all in a single procedure. Fast and easy, you can even come in during your lunch break and return to work after! Thermage® uses radiofrequency technology to heat the deep, collagen rich layers of your skin. The heat helps tighten existing collagen and stimulate the formation of new collagen, which reduces sagging, renews contours, and improves the smoothness and texture of the skin’s surface. Comfort Pulse Technology, including a vibrating handpiece delivers enhanced patient comfort.

On the face, Thermage® can treat sagging skin, loose jowls, lack of definition in the jaw line, sagging neck skin (“turkey neck”), wrinkles and fine lines, and lack of definition in the lips. Around the eyes, Thermage® can treat under eye bags, hooding, rough texture on the eyelids, wrinkles and fine lines, and other contributors to tired looking eyes. Elsewhere on the body, Thermage® can treat wrinkled, crepey, sagging or bulging skin as well as the appearance of cellulite!

New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Thread lift

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There are dozens of various ways to deal with jowls:

Mesotherapy (yes in small areas it does work) but it may require several treatments and may be quire tender;

Lipo - you may choose to have microlipo done with small cannulas to decrease the appearance of jowls but it will do nothing for cheeks.  Adding cheek augmentation with fillers can help, though;

Thermage, Ultherapy, other RF methods can also be helpful.

Thread lifts can be performed as Aptos suture, or Featherlift, or others, however, in my experience, the results are short lived.

And finally a variety of facelifting techniques.

To decide what is right for you, I suggest to define what you are looking for.  Is it a short term improvement that you can be happy with?  Or are you looking for a more permananet solution, then a facelift or mini facelift is the answer. 

By the way, mini facelift does not mean skin only.  As the matter of fact, I do not thing the minifacelift by itself has any specific meaning.


Boris Volshteyn, MD, MS
East Brunswick Plastic Surgeon

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.