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 43

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
4.8 out of 5 stars 57 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
4.9 out of 5 stars 28 reviews

The Non-Surgical Alternatives to a Necklift

You have a few options. It depends on what you’re most comfortable with, surgical or non-surgical. A facelift is a surgical route, but we do offer minimally invasive treatments, such as ThermiTight Rf, which uses radiofrequency technology to help tighten the skin from underneath. Non-invasive treatments, include Thermage, Ultherapy, and Exilis.
Choosing the right procedure for your aging pattern is the key to getting the results you want. There are several procedures that can sculpt a tighter jawline, but the key to picking the right one is to understand in detail which of the following components of aging is creating the problem – skin, facial volume/fat, muscles, or some combination of these three. I’m going to link below to how I determine that. It’s a nuanced science, so be sure to have a cosmetic surgeon you trust help you select the right procedure to address your aging where it matters most.
If Thermage did not work for you, it may be that loose skin was not the culprit, or at least not the only culprit. Thermage works to tighten and tone skin from the surface with radio-frequency, rebuilding collagen and elastin. Thermage can take a few treatment rounds, and up to 6 months after the final round, to see full results. So first, make sure you’ve reached the full result with Thermage.
Next, let’s talk about the consistency of your jowls. Do they have many, small folds of very thin skin? This is usually not the case for a 40-something patient, unless you’ve recently experienced a significant weight loss. More likely, I imagine you are seeing a bit of thickness to your jowls, which really aren’t pinchable so much as they make your jawline look bulky. If that sounds more like your concern, you would want to consider a procedure that’s more than skin-deep. So Ulthera and Exillis likely won’t make you happy either – cross those off your list. You could consider a minimally invasive tightening treatment called ThermiTight –which is a thin probe placed under the skin to deliver radio frequency energy, and provides some tightening of the muscles and connective tissues as well as skin. Radio Frequency does have a small ability to sculpt fat, so if your fat deposits are quite limited, that can be an option.
If your cheekbones have lost some of their height, Voluma or Restylane Lyft might be an option. These fillers help replace the lost volume in the cheeks. Believe it or not, a lot of women lose fat in their cheeks during their 40s, and that leads the skin to drape down and collect on the jawline. Fat transfer can provide a more permanent solution.
Finally, 43 is not too young for surgical intervention, if you have the signs of aging that are best treated by surgery: changes to fat, muscle, and skin. I see many women your age who say the same thing – ‘I’ve been told I’m too young, but I want to do something that really works.’ Doing the right procedure now will help you achieve the results you are looking for.
I highly recommend you see a cosmetic surgeon who offers all of these options for a candid and unbiased consultation.

Mark Karolak, DO, FAOCO
Bridgewater Facial Plastic Surgeon
5.0 out of 5 stars 34 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
4.9 out of 5 stars 11 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.

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, FACS
Beverly Hills Facial Plastic Surgeon
3.6 out of 5 stars 10 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
4.4 out of 5 stars 84 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 249 reviews

Improving the Jawline with Lite-lift™

If you are deemed a candidate, Lite-lift™ may be an option for you. Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. The LiteLift™ is an innovative facelift developed by board-certified plastic surgeons Dr. Larry Nichter and myself which benefits many male patients. The goal of the #LiteLift is to provide a less invasive natural looking option for both men and women desiring to refresh their appearance with less downtime and risks. The LiteLift® is a “real” facelift, which does address the underlying muscle, tissue and overlying skin.
The technique requires limited incisions and takes a vertical lifting approach, in contrast to the traditional facelift, which requires extensive incisions and lifts or pulls the face towards the ears horizontally. The modern techniques used allow us to perform most LiteLift® procedures in the office under local anesthesia. Also, removing the risk of general anesthesia opens the door for more people to pursue facial surgery. All too often people do not move forward with undergoing the desires facelift surgery due to their overwhelming fear of the risks associated with general anesthesia.

This is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.
The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. They also have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well definedOlder patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 90 reviews

Alternative to a traditional facelift

Recently I have encountered many patients like yourself who have early jowling and laxity along their jawline/neckline but who are too early for a traditional face and neck lift. Many have tried skin tightening technologies and lasers, but have not been able to get the tightness they really deserve.

For these patients, I offer a deep plane minilift procedure that only takes ~2.5 hours and may be performed in the office. Many of the incisions are the same as a traditional face/neck lift (around the ears), however, less surgery is required in the face and neck area. This results in an amazing result that settles in more quickly (recovery time is about 1-2 weeks). I believe this is the best "bang-for-your-buck" option for patients like yourself.

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 15 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.