Chin and Prejowl Augmentation in the Management of the Aging Jawline

In principle, to achieve the most natural and harmonious rejuvenation of the face, all changes that result from the aging process should be corrected. Traditionally, soft tissue lifting and redraping have constituted the cornerstone of most facial rejuvenation procedures. Changes in the facial skeleton that occur with aging and their impact on facial appearance have not been well appreciated. Accordingly, failure to address changes in the skeletal foundation of the face may limit the potential benefit of any rejuvenation procedure. Correction of the skeletal framework is increasingly viewed as the new frontier in facial rejuvenation. It currently is clear that certain areas of the facial skeleton undergo resorption with aging. Areas with a strong predisposition to resorption include the midface skeleton, particularly the maxilla including the pyriform region of the nose, the superomedial and inferolateral aspects of the orbital rim, and the prejowl area of the mandible. These areas resorb in a specific and predictable manner with aging. The resultant deficiencies of the skeletal foundation contribute to the stigmata of the aging face. In patients with a congenitally weak skeletal structure, the skeleton may be the primary cause for the manifestations of premature aging. These areas should be specifically examined in patients undergoing facial rejuvenation and addressed to obtain superior aesthetic results.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.Electronic supplementary materialThe online version of this article (doi:10.1007/s00266-012-9904-3) contains supplementary material, which is available to authorized users.

show abstract

“…Jowls appear at a younger age in patients with microgenia because of the relatively inadequate skeletal support in this area [31]. …”

Section: Resultsmentioning

confidence: 99%

Changes in the Facial Skeleton With Aging: Implications and Clinical Applications in Facial Rejuvenation

Mendelson¹,

2012

View full text Add to dashboard Cite

show abstract

“…In the setting of a prejowl sulcus and commissuremandibular groove, rhytidectomy alone will often not adequately address this irregularity and is significantly enhanced with concurrent mandibular augmentation. 11 Mild prejowl soft tissue deficiencies and commissure-mandibular grooves may often be augmented with filler injections, as well.…”

Section: Preoperative Analysismentioning

confidence: 99%

25 Aesthetic Mandibular Implants

2016

Facial Plastic and Reconstructive Surgery

View full text Add to dashboard Cite

“…As life expectancy extends and society increasingly places a high premium on youth and beauty, refinements in techniques for facial rejuvenation have become more evident in the literature [1][2][3][4][5][6][7][8][9][10]. According to the American Society for Aesthetic Plastic Surgery, over 119,000 facelifts, 24,000 browlifts, and 153,000 blepharoplasties were performed in 2012.…”

Section: Introductionmentioning

confidence: 99%