Fred G Fedok1, Harry Mittelman2
1Fedok Plastic Surgery, Foley, Alabama.
The prejowl sulcus is a facial contour deformity that develops with age due to changes in bone and soft tissue. Correcting this deformity often requires more than skin tightening alone. Surgeons may use implants, fillers, or fat transfer to restore volume in the lower face. The best method depends on the severity of the deformity, patient anatomy, surgeon expertise, and patient preferences. The authors suggest that a tailored approach is necessary for optimal results. No single method is suitable for all cases, and a combination of techniques may be required.
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Area of Science:
Background:
The prejowl sulcus is a distinct facial feature shaped by aging processes. It forms due to structural changes in the lower face, including bone atrophy and soft tissue loss. These changes are localized and involve the mandible and surrounding tissues. Prior research has shown that aging affects the mental region through fat atrophy and ligamentous laxity. The prejowl sulcus often becomes more pronounced with time. No prior work had resolved how best to correct this deformity. Surgeons have long sought effective methods to restore facial contour in this area. Correction typically requires more than skin tightening alone.
Purpose Of The Study:
This paper aims to clarify options for correcting the prejowl sulcus. The goal is to compare available techniques for volume replacement in the lower face. The specific problem involves deciding between implants, fillers, or fat transfer. The motivation stems from the complexity of this anatomical region. Surgeons need guidance on selecting the most appropriate method. The study considers factors like deformity severity and patient anatomy. It also addresses surgeon expertise and patient preferences. The focus is on practical decision-making in facial contour surgery.
The prejowl sulcus is a facial contour deformity caused by aging-related changes in the lower face.
Correction involves volume replacement using implants, fillers, or fat transfer.
Rhytidectomy alone does not address the volume deficit in the prejowl sulcus.
Factors include deformity severity, patient anatomy, surgeon skill, and patient preferences.
Fat transfer offers longer-lasting results and uses the patient's own tissue.
Main Methods:
The authors review anatomical and clinical data on the prejowl sulcus. They examine the role of rhytidectomy in combination with volume replacement. The methods include analyzing the use of solid implants in facial contouring. They also consider the application of dermal fillers for volume restoration. Fat transfer techniques are evaluated for their suitability in this region. The approach involves comparing these methods based on clinical outcomes. The study does not introduce new surgical techniques but synthesizes existing ones. The focus is on decision-making rather than procedural innovation.
Main Results:
The prejowl sulcus correction often requires volume replacement beyond skin tightening. Solid implants provide structural support for severe deformities. Fillers offer temporary volume with minimal invasiveness. Fat transfer provides longer-lasting results with autologous material. The choice of method depends on the patient's anatomy and deformity severity. Surgeon skill and patient preferences influence the final decision. No single method is universally superior for all cases. The combination of techniques may be necessary for optimal outcomes.
Conclusions:
The authors propose that no single method is suitable for all prejowl sulcus cases. The decision to use implants, fillers, or fat transfer depends on multiple factors. These include the severity of the deformity and the patient's anatomical features. Surgeon experience and patient preferences also play a role. The study emphasizes the importance of individualized treatment planning. It suggests that volume replacement is essential in most cases. The findings support the use of a combination of techniques when needed. The authors recommend a tailored approach based on clinical judgment.
The authors propose a tailored approach based on individual patient factors.