Mandibular Ligament and the Prejowl Sulcus Explained

This study investigates the anatomy and aging process of the prejowl sulcus and mandibular ligament, comparing two facelift techniques: mandibular ligament release and fat grafting. Involving 50 patients, the study found that fat grafting resulted in greater improvement in jowl correction and prejowl sulcus appearance, with a mean postoperative grade improvement of 2.0 versus 1.6 for ligament release. Fat grafting also had fewer adverse effects. The findings suggest that prejowl sulcus issues are more related to subdermal soft tissue atrophy than ligamentous contracture, and that volumetric fat grafting is a more effective and safer solution. Over 1,900 cases observed over 10 years showed improved outcomes with lipofilling, challenging the traditional view of the mandibular ligament's role in jowl formation. The study concludes that volumization is a more effective approach in facelift surgeries than extensive ligament release.