I was able to catch the Oprah show on 11/11/04 which showed many new non surgical techniques in facial rejuvenation. An LA dermatologist showed Thermage, Thread or Feather lifts and fat injections. In my opinion, the post-procedure photos showed minimal facial shape changes but nice new hairdos and full makeup (makeup is not allowed in presentations at plastic surgeon meetings as it alters comparability of the result).My office has been inundated with telephone calls about the Thread or Featherlift as an alternative to facelift for facial rejuvenation.
The threadlift consists of a barbed suture threaded beneath the skin from the temple hairline into the subcutaneous tissues and then tightened to lift the face. Conveniently this can be performed by anyone, even nurses or physicians trained in skin but not plastic surgery. Lets hope none of the important facial nerves that control facial expression and movement are skewered in the process. The results on the show had visible lines where the sutures were suspending the face. Imagine a visible wire hanger through a sheer silk blouse. I suspect the suture will "cheese wire" through the tissues in just a few weeks allowing the skin to fall back into it's pretreatment position.
Jowls are caused by sagging of the deeper SMAS or musculo-aponueurotic system of the face. In my opinion, jowls can only be addressed with a surgical facelift performed by a plastic surgeon not a dermatologist.