Alternative Procedure to Tighten Jawline?

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.

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.

While a full facelift usually tightens the face and neck, a minilift is designed to concentrate on the jowls.  The scar is smaller and does not extend behind the ear.  In my experience, this is an excellent option for younger patients.  When a bit of fat transfer is added, the results can acheive very long lasting rejuvenation to the jowls. 

For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers like Revanesse Versa - a filler known to limit swelling and give subtle, soft enhancements - or Radiesse. Using a cannula to limit pain and swelling, we inject on the bone in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. I would suggest getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

The options for management of early jowl visibility can be summarised as camouflage or reduction. Camouflage can be achieved by using injectable fillers or fat transfer in front and behind the jowl to produce a blending effect towards the chin and towards the angle of the jaw. This approach makes the jawline slightly stronger.The reduction interventions can be with or without skin reduction for tightening and the short scar facelift is the intervention that involves skin reduction.Interventions that do not involve skin reduction rely on a slide volume reduction in the jowl and stimulation of the collagen in the area to firm up the tissues. Facetite is a typical example.If the jowls are "empty" the tightening interventions tend to be less effective and the lower facelift is likely to be more appropriate.

Thank you for the question.  Certainly one of the earlier signs of age is the loss of sharpness of the jawline contour.  I never think age should be the main component in deciding the treatment options.  It really is more about the clinical situation, patient’s desire on the final result, and the patient’s situation in regards to recovery time and financial comfort.  In our practice, we offer the list of options from least aggressive to most aggressive emphasizing that more aggressive usually is synonymous with more result and longevity.  The list is too long to go through here.  I certainly think that the first line of treatment to consider are various skin tightening machines such as Ultherapy and Thermage, knowing there is a limit to their effectiveness.  There are now more minimally than invasive technologies such as micro needling with RF, Precision lift using laser assisted liposuctionmg, and subdermal RF such as Facetite.  They all have pros and cons.  The next level up from this are surgical options such as limited lower facelift  to full facelift.  It is very important to discuss these options with an experienced board certified plastic surgeon.  I think it’s important that the practice have all these options available so a truly accurate recommendations and expectations can be discussed.

For early skin laxity then there are a number of skin-tightening lasers such as Thermage, SkinTyte and Ultraformer III that improve skin laxity with minimal or no down-time. These however need to be continued for ongoing improvement.The use of dermal fillers can also disguise the presence of early jowls by smoothing out the contour along the jawline.For more advanced skin laxity then surgery - lower facelift and necklift is the best option, giving you a long-lasting result

Surgery is not for everyone. In today's day and age, there are many surgical and nonsurgical options to address various concerns one has for their face as they age.
In general, surgery is one of the best ways to address jowls. However, skin tightening and all sorts of injectables can definitely help significantly especially for patients that are not interested in surgery. If you're ever interested in surgery, the procedure is much different than what you're probably reading about online. A short scar facelift that addresses the jowls & marionette lines can typically be done under local anesthesia in the office, usually in as little as 20 to 30 minutes. There are usually no drains, recovery is quick and most patients take no narcotics.
I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and never be pushed out with just one suggestion. Ultimately there are pros and cons to every procedure whether it's surgery or not surgery. It should always be your choice. I have had 80 year old patients be very happy without having had any surgical procedures.
I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right.  

How young is too young for a facelift?  Well, that depends...  I have done a necklift on a 32 year-old.  But this was on a woman who had lost 150 pounds...  Most individuals are not a candidate for any facial or neck surgical rejuvenation procedures until they are in their 40's.  And yes, some 43 year-olds are indeed a candidate for a tiny tweak.  Or a mini...  But - if you are not a candidate for surgery - there is always laser and fillers to consider.  Best of luck!

Normally the lost of sharpness  on the Jaw Line  is due to the loss of elasticity of the skin and also the contracture of the platysma muscle.  If you are not ready for surgery Ulterapy or Thermanage are technologies  that improved the elasticity of the skin without the need of surgery.

Jowls are sagging of the facial skin and underlying tissue over ligaments attaching the skin to the bones that can cause a droopy face even in the mid 20s and 30s. They can never be corrected by  filling the face with fillers alone.
There are various types of facelift procedures that can be helpful to different age groups. A mini-facelift working on SMAS and minimal scar can help a young patient with lower face sagging (early jowls) however an older patient with sagging of the brows, midface and neck would require a full face and necklift. A facelift procedure involving pulling the SMAS should be performed for best results on the jowls. I personally in many among other techniques use the composite mini-facelift technique where a SMAS flap is elevated with minimal skin dissection, a very quick recovery and very long lasting result  (ideal for younger patients). Some parts can also be filled with fat grafting (Lift & Fill) to enhance to overall result and make you look even younger.
In general I advice my young patients to undergo preventative care procedures. These include regular botox injections, fat grafting if a depletion in volume is starting to occur and superficial skin tightening procedures that DO NOT damage the underlying tissue (a good option is needle RF). While these procedures usually make the younger patient looking for facial rejuvenation happy, not all will be satisfied if the deformities are severe (regardless of age). As a rule of thumb, if there is sagging of tissues and excess skin, a facelift operation is inevitable!
Hope this helps,
Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey