If you have "jowls" this is sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. An endoscopic type facelift won't provide skin removal nor proper SMAS dissection and re-suturing.My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-op I combine whatever facial shaping that's necessary with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. For women it's creating a heart shaped face while making a male face more chiseled and angular.Hope this helps.