Are you in your late 30s or 40s and starting to notice that your jawline is not as defined as before? Sagging is likely milder and you probably don’t need a rhytidectomy or surgical face lift just yet, but you can definitely consider non-surgical options such as threadlift, HIFU, fillers and Botox to restore youthfulness. Remember, many times a subtle change can make all the difference. Let’s dive into it…
The jawline is the lower edge of the side of the face which separates the jaw and neck. A sharp, defined jawline is not only regarded as a marker of youth and beauty, but also health and fitness. At any age, a well-defined jawline can be achieved to help show off a more youthful and healthier you.
A sagging lower face or jowling resulting in loss of continuation of the jawline is an indicator of facial aging and often has a significant impact on a person’s appearance. Other common lower face concerns include perioral wrinkles (fine lines around the mouth), nasolabial folds (laugh lines) and marionette lines (lines that run from the corners of the mouth to the chin). These signs are due to a combination of bone resorption, decrease in tissue elasticity, redistribution of fat downwards and gravity causing tissues to droop as we age.1
To effectively treat the lower face and jawline, non-surgical treatments should target the respective causes with the aims to lift and contour. In this article, I will attempt to simplify this treatment approach.
A physical examination by your doctor is vital to determine the factors that result in a poorly defined jawline and the degree of severity. Non-surgical options are best for patients who have mild to moderate fat obscuring the jawline, skin laxity around the jawline and bone resorption causing a loss definition at the angle of the jaw. Options include using threadlift, energy-based devices such as high-intensity focused ultrasound (HIFU), fillers and botulinum toxin.
Skin laxity and jowling as a result of redistribution of fat downwards can be addressed with threadlift and HIFU. Both are safe and effective non-surgical options when performed by an experienced doctor.
Below are 4 practical factors to consider:
There are a couple of small needle insertions with threadlifting whereas HIFU is a needleless procedure that utilises equipment to deliver energy into the skin at various depths. Surgical threads that are biocompatible and dissolvable are placed to lift the jowls and tighten the jawline. Typically, 2 to 6 threads are placed per side of the lower face depending on how large the jowls are and the degree of skin laxity.
Contrary to popular belief, threadlifting done by an experienced doctor is more invasive but can be less painful compared to HIFU. By taking steps to ensure maximum patient comfort such as through the use of adequate topical anaesthesia, cold compression and/ or oral analgesia, either procedure can be performed in a more comfortable and tolerable manner.
In general, there may be swelling and/ or bruising with threadlifting at the points of insertion of the threads. These will usually subside on its own in a couple of days with the aid of proper post-treatment care which should be advised. On the other hand, no to minimal downtime (a blush tone) can be expected after HIFU treatment. Most patients head back to work straight after a HIFU lunch-time treatment.
Both treatments can yield immediate results. However, threadlifting will show a more significant degree of skin tightening compared to HIFU immediately post-treatment.
Both procedures will continue to provide further skin tightening results from 3 to 6 months due to the body’s natural collagen stimulation and remodelling, with threadlifting (using FDA approved Silhouette Soft) results lasting up to 2 to 2.5 years and HIFU results lasting up to 1 year.
Silhouette Soft threads dissolve in about 1 to 1.5 years post-treatment. After that, the effects of the threadlift are further maintained for another 0.5 to 1 year depending on patient factors such as genetics and lifestyle.
In patients with bone resorption especially at the angle of the jaw, fillers can be used to restore and provide jawline definition. By injecting fillers directly to the jawline, the edge of the angle of the jaw and jawline can be enhanced.
Typically, 1 to 2 syringes of fillers may be needed per side of the jawline, based on the patient’s anatomy, degree of bone resorption with aging and how much definition is desired. The results are immediate and typically can last between 9 months to 2 years, depending on type of filler used. The two broad categories of fillers used for the jawline improvement are hyaluronic acid (HA) based fillers and collagen stimulators (calcium hydroxyapatite and polycaprolactone). In general, collagen stimulators last longer and provide more definition as compared to HA fillers due to the former’s higher G’ property. The higher the G’ of a filler, the higher the ability to withstand shearing forces2 and therefore provides better projection and definition. Hence, collagen stimulators are a good option for jawline contouring but should be performed by an experienced injector due to it being technically more challenging and that it is almost irreversible once injected.
In addition, fillers can be used to fill lines such as perioral, nasolabial and marionette lines of the lower face that are associated with aging. By softening these lines, the lower face is immediately rejuvenated in a natural fashion.
In selected patients who present with large masseter muscle that obscures the posterior (back) part of the jawline, botulinum toxin can be injected to slim this muscle. This will cause the posterior jawline to be more obvious and at the same time contour the lower face towards a more “V-shape”, which is associated with both youth and beauty.
In conclusion, addressing the lower face and jawline is and will continue to be popular amongst anti-aging treatments as we continue to recognise its importance. While improving the appearance of lines and wrinkles is pertinent, contouring and restoring jawline definition can have a significant impact on your facial aesthetic profile as a whole. Therefore, it is important that you are aware of the range of treatment options available and how each of them can be used by your doctor to address specific concerns of lower face aging.
Written by Dr. David Deng,
Disclaimer: The material contained in this is for informational purposes only and do not constitute medical advice. The content is not intended to be a substitute for doctor's advice, diagnosis, or treatment.