Besides surgery, what is the best way to tighten the jaw line? What is best way to increase collagen?

Question

I’ve had sofwave and threads before. I am 50 and see my sinking and fat loss.

Mark Beaty, MD · Answer

For the most significant improvement in jawline definition and skin laxity, surgery would generally be the best option and can provide the most natural, long-lasting results. At 50, some of the changes you are noticing may be related not only to skin laxity but also to volume loss and changes in the underlying facial tissues.

If you prefer to avoid surgery, Ultherapy is another option to consider. It uses focused ultrasound energy to target deeper tissue layers than Sofwave and can stimulate collagen production, potentially providing some tightening and lifting.

Sculptra is another option worth discussing, as it is a biostimulator that encourages your body to produce collagen over time and may help restore some of the volume lost with aging. Traditional microneedling and RF microneedling can also stimulate collagen production and improve skin texture and firmness, although they generally have more limited effects on significant sagging.

The most important consideration is having realistic expectations. Energy-based devices can provide some degree of tightening and lift, but the results are typically subtle compared with what can be achieved with a surgical facelift.

Since you have already tried nonsurgical treatments such as Sofwave and threads and are still noticing sagging and volume loss, it may be time to explore whether surgery would better address your concerns. I would recommend consulting with a board-certified plastic surgeon or facial plastic surgeon to discuss your options. An in-person evaluation can help determine whether additional nonsurgical treatments are likely to provide meaningful improvement or whether a surgical approach would be more appropriate for your goals.

Wutinan Sithipolvanichgul, MD · Answer

At 50, especially if you are noticing both sagging and facial fat loss, I would look at the face as a whole rather than focusing on collagen stimulation alone.
Non-surgical treatments using ultrasound or radiofrequency can stimulate collagen remodeling and may improve mild to moderate skin laxity. However, if volume loss is also contributing to the change in your jawline, tightening alone may not give you the most balanced result.
The right approach depends on your skin quality, degree of laxity, facial volume, and underlying structure. In some patients, a combination of skin tightening, collagen stimulation, and carefully selected volume restoration may be more appropriate than relying on one treatment alone.
Since you have already had Sofwave and threads, I would recommend an in-person assessment before deciding on your next treatment.
Wutinan Sithipolvanichgul, MDMember, American Society for Laser Medicine and Surgery (ASLMS)

Paul Flashner, MD · Answer

NeoGen can be a useful skin-tightening treatment because it combines controlled thermal energy with collagen remodeling. It uses nitrogen plasma to deliver controlled heat into the skin. This can cause some immediate contraction of existing collagen fibers. The controlled thermal injury activates the skin's healing response, including fibroblasts that produce new collagen. Over time, this can improve firmness and elasticity.  Some tightening may be noticeable relatively soon, but the more meaningful remodeling occurs gradually over the following weeks and months.

Nelson Lee Novick, MD · Answer

The simple answer to the question is to consult with a board certified cosmetic dermatologist filler injection expert to discuss the use of a robust HA contouring filler to better define and straighten the jawline. If still necessary for further improvement, you might also discuss the use of targeted microdroplets of Botox injected at intervals along the jawline and immediately below. This technique, known as targeted Botox by itself or in connection with HA fillers can have a synergistic effect for straightening the jawline and tightening the upper neck immediately below the jawline. Both procedures can be done in on treatment sessions or in two separate sessions, if so desired. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

At 50, it’s very common to notice a combination of skin laxity, jowling, and loss of facial volume. When the face is losing volume, simply tightening the skin may not fully address the “sinking” appearance.

Since you’ve already tried Sofwave and threads, I would approach this a little differently. For someone with noticeable volume loss, restoring volume and improving collagen quality together can often create a more balanced, natural-looking result.

For collagen stimulation, treatments such as Sofwave, radiofrequency microneedling, certain lasers, and biostimulatory injectables such as Sculptra can stimulate your own collagen production. Results are gradual and usually develop over several months rather than immediately.

For the jawline specifically, if the issue is primarily loose skin, energy-based tightening can help. If the jawline looks less defined because of volume loss, carefully placed filler or a collagen-stimulating treatment may provide better structural support. The key is not to overfill the lower face, because too much product can actually make the area look heavier.

At home, the most important collagen-preserving steps are daily broad-spectrum SPF 30–50 and a retinoid, provided your skin tolerates it. A healthy diet with adequate protein, avoiding smoking, and maintaining stable weight can also support overall skin health.

The important thing is that collagen stimulation and volume restoration address different problems. Based on your description of both sinking and fat loss, I would focus less on simply doing more tightening and more on determining how much of the change is from laxity versus volume loss.

Skin Social · Answer

Besides surgery, there are multiple options you can consider including Agnes RF, microneedling, and consistent skincare (just to name a few). Agnes RF can be especially helpful/a great option if your concern is laxity around the jawline because it targets the deeper tissue and can help with both skin tightening and contouring. Microneedling works more on stimulating collagen and improving overall skin firmness and texture. 
For collagen, I’d focus on retinoids, vitamin C, and daily SPF. Retinoids have some of the strongest evidence for stimulating collagen over time, while sunscreen is essential because UV exposure breaks down collagen. The key is being consistent &mdash;procedures can give you a boost, but maintaining the results really comes from good skincare and protecting your skin long-term!
I hope this helps!

Laser Skin Solutions · Answer

Addressing structural volume loss and lower facial laxity without going under the knife is one of the most common requests I see from clients in their 50s. Having tried modalities like Sofwave or threads previously means your skin has already experienced targeted ultrasound and structural support, but ongoing collagen depletion requires continuous stimulation. To tighten the jawline and rebuild lost density, my clients achieve the best results when we combine micro-focused ultrasound or radiofrequency microneedling with biostimulatory treatments. These modalities safely trigger your body's natural neocollagenesis deep within the SMAS layer, lifting and firming the jowls naturally while improving overall skin elasticity.

Besides surgery, what is the best way to tighten the jaw line? What is best way to increase collagen?

Answers (7)

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