Can a thread lift help jowls along the jawline?

If gently lifting your jowls with your hand makes your jawline run smoothly again, a thread lift may help by lifting the sagging tissue. If the jowl holds thick fat, the chin area in front of it has hollowed, or your neck skin is very loose, some of that is hard to address with threads alone. That's why your doctor first works out what your jowls are actually made of before choosing a treatment.

Why jowls stop at the jawline

Along the edge of the jawbone is a membrane (the mandibular septum) that anchors the skin to the bone. As fat from the lower cheek moves down, it catches on this membrane and pools above it, creating a bulge. That bulge is the jowl. Research has also confirmed that jowl fat sits in a separate compartment from deep cheek fat.

(Evidence: US cadaver anatomy study of 16 hemifaces, 2008)

So even jowls that look alike call for different approaches, depending on how much comes from descended tissue, built-up fat, and the hollow groove in front of them.

When a thread lift is considered

• Pulling the cheek in front of your ear up and back with your fingertips straightens your jawline almost into one line.
• When you pinch the bulge, you feel loose skin more than thick fat.
• You also have sagging in your cheeks and beside your mouth.
• Your neck skin still has relatively good firmness.

In these cases, threads lift descended tissue up and outward and hold it in place. Rather than treating the jowls on their own, the cheeks and jawline are usually planned together, in one direction.

When other options are discussed too

• When there's thick fat. If fullness remains after lifting, your doctor will also discuss ways to reduce fat.
• When the area in front of the chin is hollow. If the spot just in front of the jowl, beside the chin, is sunken, that groove makes the jowl stand out more. For this groove, filling rather than lifting is discussed.
• When the skin is thin and very loose. Options for skin firmness are considered separately.
• When sagging extends into the neck. If the loose area is extensive, your consultation lays out all the options, including surgery.

There's no single right answer; the plan is matched to the mix of factors that make up your jowls. If several are involved, the treatment is staged.

Recovery after treatment

• Swelling and bruising often settle within a few days to one to two weeks.
• You may feel tightness for a while when you move your jaw a lot.
• Rarely, the skin can dimple or a thread can be felt.
• How long results last varies from person to person. A review pooling multiple studies also concluded that evidence for long-lasting results is still limited.

(Evidence: literature review, 2018; comprehensive review, 2019)