AskID: loose sagging skin on jawline

We asked Prof Niki Ralph:
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‘A facelift is a cosmetic surgical procedure that lifts up and pulls back the skin on the face to result in a tighter and smoother appearance. It is very effective on patients who have sagging around the lower half of the face, jowls and neck.

However, facelifts are a big deal and may require a patient to schedule a substantial amount of recovery time post procedure, which is why many patients are now seeking non-surgical alternatives, with less downtime in order to rejuvenate their appearance.

Ultherapy® is an non-invasive procedure that harnesses the power of ultrasound energy to lift and tighten the skin naturally—without surgery or downtime. Ultherapy is the only non-invasive procedure FDA-approved to lift skin on the neck, under the chin, the eyebrows and lines and wrinkles of the décolletage and chest.

Ultherapy is a non-surgical non-invasive microfocused ultrasound treatment that stimulates the production of new collagen and elastin deep within the skin. It uses precise ultrasound energy to target the deep structural layers of the skin without disrupting the skin’s surface. After treatment, the body’s tissue repair process stimulates the production of new collagen and elastin, creating a natural lifting effect.

It lifts, sculpts and tightens skin from the inside out and is the only non-invasive procedure FDA-cleared and EU CE mark certified procedure to lift the upper and lower face, under the chin, neck and on the eyebrow as well as improve the appearance of lines and wrinkles on the décolletage.

Unlike lasers, radio frequency, surgery and other technologies, non-surgical Ultherapy® bypasses the surface of the skin to deliver the right amount of ultrasound energy at the right depths and the right temperature. This energy triggers a natural response under the skin, jumpstarting the regenerative process that produces fresh, new collagen.
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During the treatment the skin might appear flushed at first, but the redness should disappear within a few hours. Treatment time is approx. 60-90mins. While Ultherapy® won’t duplicate the results of a facelift, it’s a clinically proven non-invasive alternative.

Exilis Ultra 360 is another treatment alternative, a radiofrequency and ultrasound device which heats the skin and subcutaneous fat to increase collagen product and tighten the skin while reducing excessive subcutaneous fat. It addresses many skin concerns such as wrinkles, skin laxity, sagging brows or jawline, and excessive subcutaneous fat. This treatment is suitable for the entire face and body.
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It is the only device of its kind that simultaneously applies the two very popular energies: radiofrequency and ultrasound. The combination ensures high patient satisfaction and comfort. Thanks to its built-in cooling, the Exilis system offers a comfortable and safe therapy, which precisely and efficiently targets the desired tissue. Heating of the skin with radiofrequency stimulates new collagen and elastin formation to produce visibly tighter skin. Radiofrequency treatment also causes disruption of the fat cells and their removal by apoptosis (cell death). This results in skin tightening combined with fat reduction.
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Dermal fillers may also be used to augment facial shape and volumise certain areas which begin to sag as we age. By injecting dermal fillers into the face, you can create a smoother, fuller, and more contoured facial shape by smoothening the wrinkles and reducing the depth of the folds and hollows of the face.
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Filler can be used to augment cheeks to enhance their shape, add volume to the nasolabial fold and laughter lines, increase volume to fill out gauntness in the lower cheek or temple area, as well as filling out depressions under the eye area. Facial asymmetries, down-turned mouths and jawlines that require definition can also be effectively addressed with dermal fillers.
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There are hyaluronic acid fillers – like Juvederm or Restylane - which, simply put, work by absorbing water to create plumpness or fullness. Different fillers, depending on their consistency, are used to contour different areas of the face. ‘Thicker’ fillers are used in areas where you need structural support such as the temple, cheekbones, jawline and chin.

Whereas fillers with a ‘thinner’ consistency are used on the nasolabial folds – that run from nose to mouth – and the marionette lines around the mouth.
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Other fillers, such as Radiesse and Sculptra, work by stimulating the production of new collagen over time, forming a lattice within the tissue that provides a framework for your body to produce its own collagen.
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Suitable candidates include someone who is keen to maintain a youthful ‘fullness’ of face or someone who is bothered by facial asymmetry, a down-turned mouth or lips or jowling/jawline that needs more definition.
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The results should be a fresher apperance, with lines smoothed and cheeks slightly lifted and subtly contoured. One should look exactly like yourself but refreshed, more youthful with the skin imperceptibly ‘plumped.’
There may be a little bruising, redness and swelling post procedure. Patients are advised to avoid strenuous exercise for 24 to 48 hours to minimise swelling, as well as sleeping upright on their back, but most resume regular activities immediately after the treatment.
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Results last between months up to 2 years depending on the filler used and where in the face it is administered.
While dermal fillers and non-invasive treatments can certainly not achieve the result of a surgical facelift, they are a great option for patients afraid to undergo the knife and for those who can’t afford the downtime required with surgery.