When is Thermage likely to be helpful for the beginning of jowls?
Thermage works quite well for some patients and for certain problems, but has limitations. Since Thermage works by tightening existing collagen a little and stimulating new collagen production over 3-6 months, it works best on those who already have a good thick dermis (lots of collagen) and who have a lot of cells (fibroblasts) that make collagen.
As we get older, we have less collagen to tighten and fewer cells to make collagen. After the age of 50ish, Thermage can help prevent more sagging and might tighten a little, but generally you will be disappointed if you expect the jowl to disappear. Also after the age of 50ish, volume replacement becomes key and the combination of subtle tightening plus volume replacement can give a very nice result, in some patients even getting close to that of a surgical facelift if jowls are still early stage.
See other readers Thermage and Ultherapy QQuestions/Answers.
For more information about volume enhancers, read our guide on fillers.
Hope this helps, Dr. I