Thermage versus Surgery for the lower face
Thermage is a fabulous laser for skin tightening, especially the jowl area and lower face. The question is two fold - how much skin laxity do you have and whether or not you want a surgical versus non-surgical procedure. Without a photo it is impossible to know how much skin laxity you have. Thermage works on all patients and will produce new collagen and skin tightening. My patients return every two years since the Thermage produces new collagen and always improves the overall appearance.
Thermage versus surgery for the lower face
When I evaluate a new patient, I like to ask if he or she is considering surgery. Early sagging will do well with any of the noninvasive tightening procedures. I like Thermage for overall tightening of the face and jawline - I think of it like shrink-wrapping the skin. Modern Thermage is painless and without downtime. Ulthera hurts more and can bruise but can provide deeper tightening for more lax areas. However, for significant hanging skin and jowls, no noninvasive treatment will give you the same result as a surgical lift. If you have significant sagging and really don't want to do surgery, or you want to try to put off surgery, then it is reasonable to consider doing noninvasive skin tightening with Thermage or Ulthera or both. I have patients who really 'needed' surgery but instead have done Thermage every one to three years over the last decade and look better now than they did at the start despite being a decade older.
Thermage for the jowls
I recommend that you also evaluate the Ultherapy procedure for the neck and jowls. It is FDA cleared, less painful than Thermage and has great patient satisfaction rates when performed by experienced providers.
Read the Ultherapy ebook provided on the link below.
Knife vs. Heat!
It would be great to see pictures to determine if you are a good candidate for facial lifting. If you have significant facial skin laxity, are in good health, and open to the idea of surgery a mini lift would give you a bigger improvement then thermage. However, for patients with small amounts of facial skin looseness, or patients who are not psychologically, financially prepared for surgery thermage is a reasonable alternative.
It would be helpful to see your picture to make the right recommendation. Many people are delaying facelifts, or in many cases not having them. Instead, patients are seeking out an injection specialist - either a plastic surgeon, oculofacial plastic surgeon or dermatologist to discuss other alternatives. There are several non-surgical treatments are available in the US. While they are not permanent, they can bring a long-lasting improvement and with proper maintenance the results often look entirely natural. People get jowls due to multiple factors and Ultherapy is one of the excellent tool that we can use. Often, we will add volume to the face in the areas where it was lost and sometimes that gives a beautiful correction. Other times, Ultherapy alone or in combination with a less-expensive nonsurgical device such as Thermi can also produce great results. Seek a practice that offers these various services and get educated before you go under the knife.