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 46

40 year old with early jowls

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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.

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

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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

Different options to tighten the jawline

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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

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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.

Alternative procedures for tightening jawline

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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.

Radiofrequency Tightening May be Your Best Bet

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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

Jawline tightening

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I use a preauricular lift or so called mini lift to tighten the jawline in patients with only minimal sagging. I combine this with a volumizing procedure like fat injections or filler or Sculptra to the mid face area if there is volume loss. My patients love this combination and it is very powerful in rejuvenating the face with minimal cost and downtime. The scar heals very nicely. Overall in my younger patients volume is the key to a natural younger look without changing the face into something unnatural. 

Non-Surgical Treatment for Jowls

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Early jowl formation is something that a lot of women and often men do not like.  I frequently hear from patients who would like to improve this area but they are not ready for surgery.  Often, filling the hollow just in front of the jowl, the so called marionette lines, lower smile lines or pre-jowl sulcus works well to mask early jowls.  I prefer to use the long term filler Bellafill for this.  I have added link to some before and after photos of this problem that may help you see what I am referring to.

I hope that helps.

Best regards.

Improving the Jawline with Lite-lift™

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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™.

Alternative to a traditional facelift

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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.

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.