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 liftEndotine Ribbon lift
Ideal candidatesPatients with jawline flabbiness having mild-to-moderate lower face laxity but acceptable skin elasticityPatients with moderate or severe lower face laxity, thick skin, or concurrent midface aging and drooping
Age30–50 years old40–60 years old
Range of liftOverall lower face and jawline, including the skin near the chinJawline, marionette wrinkles, and upper neck
Nature of liftProximal direct lift with suturesDistant lift with implant
Type of anesthesiaIV sedation + local anesthesiaIV sedation + local anesthesia
Surgical incisionAn S-shaped incision from the preauricular to the retroauricular area (approximately 5 cm)Earlobe or scalp incision (approximately 3 cm)
Material usedLift suturesBioabsorbable Endotine Ribbon implant
Removal of skinLargeSmall
Period of recovery1–2 days3–5 days
Nerve injuryNoNo
Recovery of scar6 months3–6 months
Surgical resultsTightNatural
PersistenceApproximately 2–3 yearsApproximately 3–5 years
Foreign body reactionNoProbable