Options for Correcting Loose Jowls?

Necklifts don't address the jowl area.  All the correction is below the angle of the jaw.  An upper facelift will greatly improve or eliminate jowls.  Avoid the threadlift.  They don't work. I disagree with one of the other surgeons who recommended Thermage.  I don't think it works.

Thank you for your question. Typically during a surgical necklift the jowls are not the main priority over the neck/submentum area. If you did not address the lower part of your face (cheeks and jawline) it would make sense that the jowling would still be present. Depending on your age and the amount of laxity you could try a non-invasive device to lift and tighten, but considering you have already had a surgical procedure on your neck, you may not be happy with non-surgical results. I would suggest an in person meeting with a facial plastic surgeon to discuss all your options. Hope this helps.  

There are several minimally invasive techniques to help reduce the appearance of jowls – it’s just a question of “how much” will the minimally invasive techniques help. As a board certified plastic surgeon, I hear these concerns from patients quite frequently. Cosmetic thread lifts are one option but you state you are wary about them. Another would be microneedling with RF (radiofrequency) to help stimulate collagen formation and to tighten skin. Both require no anesthesia and the recovery time is minimal. Another option is the liquid facelift which adds filler along the posterior jawline and cheekbones to help lift the skin away from the jowls. These procedures can be helpful, but the most effective way to reduce your jowls would be a lower facelift to remove the excess skin and resuspend the tissue to a higher, more attractive position. I recommend consulting with a board certified plastic surgeon in person to discuss your concerns and to determine which treatment would be best for you.

Controlling the appearance of the jawline when the problem of jowls is mild can be matter of camouflage or actual treatment. Camouflage would be delivered by building the volume of the jawline around the jowls, with filler, fat transfer or Sculptra. These options are best when the jawline in general is a little thin.Treatment depends on whether the jowls are full or empty.If they are full, reducing the volume excess can be the answer and this can be through liposuction, either normal or energy assisted such as laser or radio frequency. If the jowls are empty, they reflect loss of skin elasticity and a mini-lift may be the most elegant solution.

With significant neck sagging you would need a neck lift / facelift with muscle tightening (platysmaplasty). At the same time, lasers treatments (Fraxel, CO2, Erbium) or microneedling RF (Fractora, Intensif) can be performed to improve crepey skin or wrinkles. You need a formal consultation, as the neck can be treated with a combination approach: - Microneedling and laser treatments for texture - Botox, Dysport, Xeomin, or Jeuveau to help the Platysmal bands - Intensif or Fractora RF microneedling for crepey skin and lifting - Injectable fillers like Belotero, Restylane Silk, and/or Juvederm Volbella to improve lines and folds - Renuvion, ThermiRF, and/or InMode FaceTite for internal tightening - Ultherapy and Thermage for external tightening - regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness - PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production See an expert for a full evaluation and treatment plan based on your individual situation and goals.

There are many options for improving laxity in the jowls, both surgical and non-surgical - which is best depends on the degree of fat present, the quality of your skin and the degree of skin laxity.If you have minimal excess fat and are relatively young and have good skin quality then liposuction will give a good result, especially if combined with a skin-tightening laser.

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.

For more advanced skin laxity then surgery - a lower facelift is the best option, giving you a long-lasting result

A minilift is surgical procedure that can be performed under local anesthesia. an incision is made in front of the ear and down to the earlobe, skin is lifted, muscles tightened and the excess skin removed. This is a very nice procedure to improve jowls, with little down time. Sutures are out in a week and you can return to normal activities in about 5 days.Machines all work a little bit to tighten the skin, but the gold standard is surgery. Once you consider the expense of using machines, you will see that a minilift is the best option both clinically and financially.And finally, a word on threadlifts: DON'T!!!

It is difficult to make a recommendation without being able to see a picture or examine you however you may wish to consider injections of HA filler (like Juvederm Voluma). Often injections of filler in the cheeks, chin and jawline can help to improve the appearance of jowls.  This may well give you enough of an effect if you are looking for a relatively modest improvement.  If you're after something more dramatic though a revision neck (and face) lift tends to give better results longterm.

Dr. Law gives an outstanding answer below and I do not want simply to repeat his spot-on analysis.  What I want to emphasize is that your jowls may be the result of either too superficial of a neck lift, or a persistent issue with your anatomy.  I recommend that you have a plastic surgeon examine and then determine the best approach based upon your underlying anatomy.  My impression is that another surgery is in your best interest followed by regular tightening with one of the non-invasive high-energy devices that are now being used by plastic surgeons.  Good luck.

Jowls are commonly treated as part of a cheek and neck lifting procedure such as a facelift. Some neck lifting techniques do not address the jawline at all, which might be appropriate for some patients, but can often leave unsatisfactory results if the jowls or jawline need to be addressed as well. Thread lifts are not something that I perform, but a cheek and neck lift is highly effective at addressing the jowls and giving long-lasting and elegant results.All the best,

If you've had a recent neck lift and your jowls are loosening, it may be a sign that your doctor was not aggressive enough.  In my mind a facelift and neck lift are essentially the same operation, but there are different approaches and methods to do this procedure, some are more extensive and longer lasting than others.  Options short of getting another facelift/neck lift (which I do agree it is a littles son for - typically for my patients a facelift/neck lift should last about 7-10 years).  Sometimes jowls appear because of bony resorption of the anterior portion of the jaw or chin.  This can be corrected with fillers or a chin implant.  Sometimes I place a small subtle chin implant at the time of facelift/neck lift surgery anticipating that the jowls will need additional correction based on a weak chin or noticeable resorption of the mandible (jaw bone).  
The other thing to consider is if after a facelift/neck lift you are noticing aging in the upper half of your face, an endoscopic forehead lift combined with a mid face lift will rejuvenate the upper portion of your face as well as improve the appearance of bowling.