Anatomy of the Jawline, Neck, and Perioral Area with Clinical Correlations

Abstract

The dramatic rise in the number of cosmetic procedures performed during the past 5 years reflects a heightened public awareness of and interest in facial rejuvenation. Concomitant with this rise has been the addition of new injectable fillers, lasers, and minimal incision techniques to the surgeon's armamentarium. Perhaps the greatest applicability of these modalities has been the rejuvenation of the perioral region, neck, and jawline, with reduced "downtime" but visible results. Signs of aging that are clearly visible in the lower third of the face include the loss of elasticity and descent of fat in the jowl region; laxity of the neck skin, muscle, and fat; development of perioral rhytids, deep nasolabial folds, and marionette lines; and the loss of definition of the lips. The purpose of this article is to highlight our approach to rejuvenation of these areas, elucidate the role of newer technologies, and provide special techniques and pearls utilized in rhytidectomy.

The posterior temporal supraSMAS minimally invasive lifting technique using soft‐tissue fillers

“…Most of the changes observed during facial aging occur in the middle and in the lower face due to the effects of gravity, which in general guides the healthcare provider to focus on these facial regions in greater detail. If additional regions are affected, fi the temple, different therapeutic approaches, and multiple sessions are needed to treat the face as a global esthetic unit.…”

Cervicofacial Rhytidectomy without Notorious Scars: Experience of 29 Years

“…Those include an endobrow midface-lift approach, 13,14 lower blepharoplasty to improve midface, 15,16 facial lipografting, 17,18 fillers, and/or facial implants. 19 For the treatment of the neck and the submandibular area in rhytidectomy, we can use different options: submental platysmaplasty with or without liposuction, mentoplasty, or nonsurgical treatments such as the use of botulinum toxin type A. [20][21][22] The cervicofacial rhytidectomy technique includes submandibular ultrasound liposuction and platysmal plication at the midline through a 2-cm incision in the submental groove.…”

Poly-l-Lactic Acid for Neck and Chest Rejuvenation

“…9,10 Superficial and medium-depth chemical peels, intense pulsed light, and fractionated resurfacing are also used for photodamaged neck and chest skin, as well as hyaluronic acid as a filler for the cervical wrinkles. 11,12 For the correction of light to moderate flaccidity, there are also devices to promote neocollagenesis through dermal warming, such as radiofrequency or infrared light. Among the limitations associated with these techniques are the high cost of the apparatus and treatments, the need for several sessions to obtain satisfactory results in some patients, and the fact that most patients consider the results poor.…”