Face contouringYou are searching for, but many people find themselves overwhelmed: "too many types of options, so I don't know which is right for me in the end." In fact, the suitability of a Treatment depends entirely on what is causing your concern.
What you will learn from this article:
- Botox,Thread liftandLiposuctionof the FaceFaceliftHow they differ and which suits whom
- Complications reported in SMAS-technique mini Facelift
- How people in their 30s and 40s think when choosing a Treatment
- Rough guide to downtime and duration of effect
Even when you start to feel self-conscious about your jawline, many people hesitate to take action out of fear of failure or uncertainty about which Treatment is right for them. This article therefore organizes the characteristics of each Treatment based on peer-reviewed evidence.
Before you look for face contouring: choosing by the "cause" of your concern is the golden rule
Even if everyone wants "the same smaller face," the cause of the concern differs from person to person. First, jawline concerns can be broadly categorized into three types.
Liftable (skin laxity)
- Jaw angles and skeletal structure: Development of the masticeter muscle (the muscle at the jaw angle) or forward projection of the lower jaw
- Fat and puffiness: Blurred appearance due to fat around the cheeks or chin
- Sagging (skin laxity): Disruption of the jawline due to looseness of the skin or fascia (SMAS)
When the cause differs, the optimal Treatment also changes significantly.
For example, Botox may be a candidate for jaw-angle fullness, but for sagging it may not provide sufficient results on its own. Conversely, if the main cause is fat, Thread lift alone may not deliver the expected effect. Therefore,Face contouringthe first step in choosing a Treatment is "understanding the cause of your concern."
Botox injection | An entry-level choice for those troubled by jaw-angle fullness
For those who think "surgery is still frightening," aBotox injection (masseteric Botox)may be an option.
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Surgical Facelift
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Liftable (skin laxity)
Botox is suitable for:
- The jawline appears wide due to development of the masseteric muscle (jaw-angle muscle)
- You have teeth grinding or jaw clenching
- You want to minimize downtime as much as possible
- You want to try a non-invasive approach first
Botox considerations
Botox is a Treatment in which botulinum toxin (a substance that temporarily blocks neuromuscular signaling) is injected into the masseter muscle. Though results vary individually, the effect typically lasts about 4–6 months, and periodic maintenance may be needed.
However, it is not that simple. As the jaw angle shrinks, sagging or blurred jawline may become more noticeable. Therefore, a comprehensive assessment matched to bone structure and skin elasticity is important.
Thread lift (suture lift) | For those who want to address sagging without cutting
For those who think "surgery is scary, but sagging is on my mind," the most commonly chosen option isThread lift(suture lift).
Liftable (skin laxity)
Thread lift is suitable for:
- Mild to moderate sagging
- High barriers to surgical procedures involving incision
- You want to address the issue step-by-step while monitoring results
Know the limits of Thread lift too
Thread lift is a Treatment in which absorbable special sutures are inserted beneath the skin to lift sagging tissue. However, though results vary individually, the effect typically lasts about 1–2 years. Also, if sagging is severe or if there is significant subcutaneous fat, Thread lift alone may not provide sufficient improvement.
Among people who say "Thread lift no longer works, no matter how many times I have it," some have sagging caused not by the skin but by the fascia (SMAS layer). In such cases, the SMAS technique discussed in the next section may be a viable option.
Cheek and chin liposuction | For those who want to improve facial "heaviness"
For concerns such as "my face looks unclear" or "my jawline is not defined," aLiposuctionmay be a candidate option.
Liftable (skin laxity)
Liposuction is suitable for:
- There is significant fat around the cheeks and chin
- Face fat is hard to lose even with dieting
- You want to sharpen your jawline
Know the sagging risk after liposuction
Because fat cells are extracted directly, the effect is said to last relatively long. However, skin sagging (skin laxity) may occur after surgery. Therefore, a treatment plan that takes into account age, skin elasticity, and fat volume is important.
If you are considering liposuction in your late 30s or beyond, we recommend consulting with a doctor about whether to combine it with "sagging (skin laxity) countermeasures" at the same time. Comprehensive planning that takes future sagging (skin laxity) into account may lead to a more natural result.
SMAS Mini Facelift | An Evidence-Based Approach to Sagging (Skin Laxity) Improvement
Anatomical basis of the surgical technique
The appropriate timing varies from person to person, so consultation with a doctor is important, but we would like patients considering Facelift to know about a surgical technique.
Liftable (skin laxity)
Worth notingMini Facelift using SMAS (Superficial Musculo-Aponeurotic System) plication— Mohammadi S and colleagues' paper is a cadaver study that provides anatomical insights. On the other hand, the current standard Facelift technique was reported for safety in research by Stuzin JM and colleagues (2018) (Reference: PubMed — Facelift-related literature). Duminy F and colleagues' (1999) follow-up survey of 35 cases serves as a historical example, but it is a small-scale and limited research result.
Clinical data on complications
- Facial nerve paralysis: Facelift generally carries risks such as facial nerve paralysis and skin necrosis. The same results are not guaranteed for everyone
- Skin necrosis: Facelift generally carries risks such as facial nerve paralysis and skin necrosis. Results may vary due to individual differences and risk factors such as smoking
- Same-day surgery (outpatient): Depending on the patient's condition, same-day surgery may be possible
Smoking is generally a risk factor that delays wound healing. It is important to confirm with your doctor beforehand regarding risks such as hematoma, scarring, and sensory abnormalities.
Why lifting the SMAS is important
The conventional method of pulling only the skin tends to create an unnaturally "tight" appearance. On the other hand, lifting the SMAS (fascia) from the foundation means the skin does not need to be pulled excessively. This may lead to a natural result and less noticeable scarring, as shown in the literature.
Why it is particularly suited for those in their 30s–40s
The literature examined patients with a mean age of 45.6 years (32–69 years), and it is considered particularly effective for early-stage sagging (skin laxity) in the 30s–40s. In addition, because only a small incision is made in front of the ear, scarring may be less noticeable compared to conventional Facelift. The ease of hairstyling regardless of hair type is also thought to be one reason why it is chosen by the working generation.
Common question: Will a Facelift make the face look unnatural?
Some patients worry that their face may become "tight-looking." The literature indicates that by lifting the SMAS and then closing the skin without tension, excessive skin pulling can be avoided. Therefore, a natural result may be expected.
Additionally, if neck sagging (skin laxity) and heaviness are a concern, performing liposuction of the neck at the same time may help refine the neck line. For platysmal (neck muscle) sagging (skin laxity), a small incision under the chin may be used. For details on each treatment, please also refer to Treatments.
"Which is right for me?" Comparison of treatment characteristics
So what is the reality? Let us organize the characteristics of each treatment.
References
- Duminy F, Hudson D. The Mini Rhytidectomy. Aesthetic Plastic Surgery. 1997 DOI
- Mohammadi S, Ahmadi A, Salem M, et al. A Comparison Between Two Methods of Face-Lift Surgery in Nine Cadavers: SMAS (Superficial Musculo-Aponeurotic System) Versus MACS (Minimal Access Cranial Suspension). Aesthetic Plastic Surgery. 2015 DOI
- Wan D, Small K, Barton F. Face Lift. Plastic and Reconstructive Surgery. 2015 DOI
Liftable (skin laxity)
※Downtime and duration of effects vary depending on the patient's condition. Please be sure to confirm with your doctor.
Moreover, any of these treatments may carry risks such as hematoma, scarring, sensory abnormalities, and asymmetry. Additionally, the phrase "a surgical technique reported to have low complication risk" is based solely on literature data and does not apply to everyone. It is important to confirm your individual condition carefully during consultation.
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Summary
- Face contouringvaries depending on the cause of your concerns (jaw prominence, fat, sagging (skin laxity)) — this is the fundamental principle
- Botox may be suited for jaw prominence, and Thread lift may be suited for mild sagging (skin laxity)
- Liposuction is an approach expected to improve jawline heaviness
- SMAS Mini Facelift safety has been reported in recent evidence (e.g., Stuzin JM and colleagues, 2018). It is considered suited for early-stage sagging (skin laxity) in the 30s–40s
- All treatments carry risks such as hematoma and scarring, so thorough consultation with a doctor before surgery is important
The appropriate timing varies from person to person, so consultation with a doctor is important. At Zetith Beauty Clinic, we propose the optimal lift-up method tailored to your face's condition and preferences. Since we provide recommendations tailored to each individual's concerns, please feel free to consult at a free consultationfirst.
Author of this article
Hiromitsu Nakamura Physician
Zetith Beauty Clinic Ginza, Osaka, Fukuoka
With a track record of research presentations at domestic and international academic conferences, Hiromitsu Nakamura is involved in technical guidance and education for Zetith Beauty Clinic as a whole. Specializing in precision rhinoplasty based on anatomical understanding, Hiromitsu Nakamura pursues natural results tailored to each patient's skeletal structure and tissues.