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Jowl Lift

The lower face refers to the area below the nasal columella and above the jawline. Its aging will commonly cause circumoral fat protrusion and laxity, mouth corner wrinkles (marionette wrinkles), and jawline sagging or loss. The jawline is located at the lowest margin of the cheek, which is most sensitive to the influence of skin aging or sagging. In the early stage of cheek laxity, the jawline is the first part to become round, which makes patients feel that they have a rounder or chubby face. Some patients also find out that their jawline is gradually disappearing or that even a double chin is showing up. The management of jawline laxity should be determined depending on individual skin thickness and laxity degree. If patients have fatty and sagging cheeks, a temporal midface temporal lift or MACS facelift may be considered first to get the instant and effective results. If patients have relatively thin and firm skin, the jawline fascia lift targeting the jawline may be considered to garner obvious results. However, if the overall lower face has an obvious laxity or more severe aging and sagging, the Endotine Ribbon lift should be seriously considered. Direct lift of the jawline, marionette wrinkles, and lower cheek via minimal incision in a simple procedure can generally produce a remarkable improvement.

Jawline suspension lift

Lower face Endotine Ribbon lift

Comparison of lower face lifts

Jawline suspension lift Endotine Ribbon lift
Ideal candidates Patients with jawline flabbiness having mild-to-moderate lower face laxity but acceptable skin elasticity Patients with moderate or severe lower face laxity, thick skin, or concurrent midface aging and drooping
Age 30–50 years old 40–60 years old
Range of lift Overall lower face and jawline, including the skin near the chin Jawline, marionette wrinkles, and upper neck
Nature of lift Proximal direct lift with sutures Distant lift with implant
Type of anesthesia IV sedation + local anesthesia IV sedation + local anesthesia
Surgical incision An S-shaped incision from the preauricular to the retroauricular area (approximately 5 cm) Earlobe or scalp incision (approximately 3 cm)
Material used Lift sutures Bioabsorbable Endotine Ribbon implant
Removal of skin Large Small
Period of recovery 1–2 days 3–5 days
Nerve injury No No
Recovery of scar 6 months 3–6 months
Surgical results Tight Natural
Persistence Approximately 2–3 years Approximately 3–5 years
Foreign body reaction No Probable