Endolift X tightens from inside, a thread lift repositions tissue that has dropped. A Karachi dermatologist explains which suits your jawline, and when you need both.
When the jawline starts to soften and early jowls appear, two treatments come up again and again: Endolift X and the thread lift. Both are done under local anaesthetic, both avoid a surgical facelift, and both can make a clear difference. They work in very different ways, though, and the better choice depends on what is causing the sag.
At the clinic: Dr. Fehmida offers both treatments. See Endolift X, thread lift or our page on sagging and loose skin.
How Endolift X works
Endolift X uses a laser fibre thinner than a hair, which is passed under the skin through a few tiny entry points. The 1470 nm laser heats the tissue from the inside. This tightens the connective fibres that hold the skin up, stimulates new collagen over the following months and can melt small pockets of fat, such as early jowls or a soft double chin.
It is a single session under local anaesthetic. You can expect some swelling and possibly bruising for a few days. Some tightening is visible early, and the result keeps improving for three to six months as new collagen forms.
How a thread lift works
A thread lift uses absorbable PDO threads with tiny cogs along their length. They are placed under the skin through a fine needle, then gently pulled to reposition tissue that has dropped, such as the cheeks or the jowls. As the threads dissolve over the following months, they leave behind new collagen that helps hold the lift.
The lift is visible straight away. For a week or two you may feel tightness, and there can be swelling, bruising or small dimples that settle. You are asked to avoid opening your mouth very wide, chewing hard food and sleeping on your face for a short while. Results last up to two years.
Endolift X and thread lift compared
| Endolift X | Thread lift | |
|---|---|---|
| What it does | Tightens from inside and reduces small fat pockets | Physically lifts and repositions tissue |
| Best for | Loose jawline, early jowls, soft double chin, neck | Dropped cheeks, jowls, a flatter mid-face |
| Sessions | Usually one | Usually one |
| When you see it | Early tightening, best at three to six months | Straight away, then collagen builds |
| Recovery | Swelling for a few days | Tightness, swelling or bruising for one to two weeks |
| How long it lasts | Often a year or more | Up to two years |
Which one suits your face?
Endolift X tends to suit you if your jawline has lost its edge, there is a little fullness under the chin or along the jowls, and the skin feels loose rather than fallen. Because it tightens and reduces small fat pockets at the same time, it is especially good for the lower face and neck.
A thread lift tends to suit you if the tissue itself has dropped, for example the cheeks sit lower than they used to and the mid-face looks flatter, and you want a visible lift without waiting months for it.
Many faces need both, or neither. Endolift X and threads are often combined, with the laser tightening the lower face and threads lifting the cheeks. If the main problem is lost volume, fillers or collagen-stimulating injections may do more than any lift. If there is a lot of heavy, loose skin, surgery will give a better result, and a good dermatologist will say so.
Is either one safe for brown skin?
Yes. Both treatments work beneath the surface of the skin, so the risk of pigmentation is low. The main points are careful technique, good aftercare and protecting the skin from the sun while it heals.
What about non-invasive options?
If you are not ready for a procedure with any downtime, energy treatments such as HIFU, Ultherapy and Emface can tighten earlier laxity with no needles at all. The change is more gradual and usually smaller, but for the right face it is enough.
How Dr. Fehmida decides
At your consultation Dr. Fehmida assesses where the sag is coming from: loose skin, dropped tissue, small fat pockets or lost volume. The plan follows from that, and it may be one treatment, a combination or a recommendation to wait. Read more about our approach to anti-ageing treatment in Karachi.
Frequently asked questions
Is Endolift X better than a thread lift?
Neither is better in general. Endolift X is better for tightening the jawline and reducing small fat pockets. A thread lift is better for lifting tissue that has dropped, such as the cheeks.
Which has less downtime?
Endolift X usually has less, with swelling for a few days. A thread lift can leave you feeling tight and swollen for one to two weeks.
Can Endolift X and threads be done together?
Yes. They work in different ways and are often combined, sometimes on the same day.
How long do the results last?
A thread lift lasts up to two years. Endolift X results often last a year or more, and the collagen it builds keeps working after that.
Does either treatment hurt?
Both are done under local anaesthetic, so most people feel pressure and some warmth rather than pain. There is some soreness for a few days afterwards.
Consultant Dermatologist and Laser Skin Specialist, MBBS, MCPS. Over 35 years in dermatology, five of them in Zurich, practising in Clifton, Karachi since 1999.
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