There is a point in most people’s forties or fifties when a facial no longer does quite enough, and a facelift still feels like far too much. The jawline has softened, the beginnings of jowls have appeared, and perhaps there is a little looseness under the chin.

Nothing dramatic, but enough to notice in photographs. That gap between skincare and surgery is where a growing number of minimally invasive treatments now sit. One of the more considered options is Endolift, a laser treatment delivered beneath the skin rather than on its surface.

How it works

Most skin-tightening treatments work from the outside in. Endolift works from the inside. A laser fibre finer than a hair is placed under the skin through a tiny entry point, under local anaesthetic, and laser energy is delivered directly into the tissue that has loosened.

The heat does two things. It causes existing collagen to contract, which produces some immediate tightening, and it prompts the body to produce new collagen over the following months. It can also reduce small pockets of fat, which is why it is often used along the jawline and under the chin.

At Endolift for the jawline at Dr Hass Clinic in Mayfair, the procedure uses the LASEmaR 1500 system and takes 60 to 90 minutes. The clinic says results develop gradually over two to six months, continue to refine for up to nine months, and typically last two to three years.

Who it suits

The best candidates have early to moderate signs of ageing rather than advanced laxity: a jawline that has lost definition, early jowling, some fullness under the chin, and skin that still has reasonable elasticity. Age, perhaps surprisingly, is not the deciding factor. “Age alone is not a deciding factor. Some patients in their late 30s or early 40s are excellent candidates, while others in their 50s may still be suitable depending on skin quality and anatomy,” says Dr Hasaneen Al Janabi, a GMC-registered doctor and member of the Royal College of Surgeons, who performs the treatment himself.

Who should see a surgeon instead

Endolift has firm limits, and the most useful thing any practitioner can do is be clear about them. It does not add volume, so it will not correct hollowness. It does not remove significant excess skin, and it will not deliver the kind of lift that surgery can.

“A surgical facelift remains the gold standard for advanced skin laxity,” Dr Al Janabi says. “It repositions deeper structures and removes excess skin, something Endolift cannot do.”

For people with heavy jowls, deep folds or a lot of loose skin on the neck, a surgical consultation is the more sensible starting point. For those who are not there yet, Endolift is often chosen as a way to delay surgery rather than replace it.

The recovery

This is not a lunchtime treatment in the way a facial is. Expect some swelling, tightness, redness or light
bruising afterwards. The clinic says most patients return to normal daily activities within 24 to 72 hours,
though it is wise to keep the following week free of important events or photographs.

The results are gradual. There is an initial sense of tightening, but the real change comes as new collagen
forms over the following months. That slow build is, for many people, part of the appeal: the result tends to
look like a well-rested version of yourself rather than something that has obviously been done.

How to choose the practitioner

With any treatment that works beneath the skin, the person holding the fibre matters at least as much as the device. Depth control, an understanding of facial anatomy and the judgement to treat conservatively all shape both the result and the comfort of the procedure.

A few questions are worth asking at any consultation:

• Will the doctor perform the treatment personally, or delegate it?
• Is the device authentic and sourced through official channels?
• What would you recommend if I am not a good candidate?
• How will you assess whether my concern is volume, skin quality or laxity?

At Dr Hass Clinic, consultations begin with a detailed facial assessment, and patients who are better suited to surgery are told so.

The considered choice

The appeal of treatments like Endolift is not that they replace surgery. It is that they offer a measured step for people who are not ready for an operation and do not want to look as though they have had one. Chosen for the right reasons, and in the right hands, that restraint is precisely the point.