Who is a good candidate for liposuction lift? It depends on whether fat or skin sagging (skin laxity) is the cause

Liposuction lift is suitable for people whose jawline fullness is mainly caused by fat, with light to moderate skin sagging (skin laxity). People with large skin excess tend to retain sagging (skin laxity) even after fat removal, and may benefit more from surgical Facelift. However, research directly comparing these two treatments combined has not yet been found.

What causes the fullness—fat or loose skin?

The primary indicator determining suitability is the balance between the amount of fat and the degree of skin laxity. Textbooks note that liposuction under the chin is effective for young people with abundant fat and minimal skin excess[1].

Conversely, problems are more likely to occur in older people with large skin excess, and Facelift may be necessary to address the excess skin[1]. This is because reducing fat alone does not lift excess skin.

What conditions make a non-surgical approach a candidate?

Ideal candidates are those with early signs of jawline sagging (skin laxity), light to moderate skin laxity, and fat under the chin. Reports on non-surgical methods to reduce subcutaneous fat describe such people as ideal candidates[2].

The same report states that such non-surgical methods cannot replace extensive surgery to the face and neck[2]. Proper selection depends on the degree of sagging (skin laxity).

Is suitability determined by age?

Age alone does not determine suitability. However, skin excess tends to increase with age, so as age increases, situations where liposuction alone is insufficient become more common[1].

Textbooks identify treatments in which facial fat is aspirated and injected elsewhere as primarily intended for people in their late 30s and beyond who seek treatments more extensive than Botox or fillers (hyaluronic acid, etc.)[3]. Age is one guideline; actual assessment is based on the skin condition observed during examination.

What changes when thread is added?

Thread lifts the skin after fat reduction. However, the change obtained with thread is not substantial. According to guidelines from the Japanese Association of Plastic Surgeons, Thread lift can be expected to provide temporary improvement, but because the effect is not substantial and duration is short, adequate explanation is required, and it is rated as recommendation level 2 (weak recommendation)[4].

There are differences depending on thread shape. U-shaped threads have greater lifting power but tend to cause more bleeding and skin depression. Straight I-shaped threads place less burden on the body but provide more modest lifting, according to reports[5]. Which is suitable depends on the degree of sagging (skin laxity).[5].

What remains unknown from research?

There are no established standard guidelines regarding the number of threads or the effects when combined with other treatments[6]. For the combination of liposuction and Thread lift, the current approach is to integrate separate reports on each treatment.

Therefore, it cannot be said that "combining treatments will make results last longer" or "you will definitely have a smaller face." It is safer to ask about what is and is not understood about each treatment separately.

Things to confirm before treatment

There are three guidelines for judgment. The first is whether jawline fullness is mainly caused by fat or skin laxity[1]. The second is whether skin laxity can be addressed within the range of non-surgical methods[2]. The third is how much change can be expected with thread and how long it will last[4].

Whether fat or skin is the main cause of fullness in your jawline cannot be determined from photos or articles alone. Including how much skin excess is present when pinched, confirm this with your doctor during examination.