Mandibular Ligament and the Prejowl Sulcus Explained

This study aimed to clarify the anatomy and aging process around the prejowl sulcus and mandibular ligament, and to evaluate different management techniques in facial rejuvenation. A retrospective review compared 25 patients who underwent mandibular ligament release during facelift surgery with 25 patients who had fat grafting of the prejowl sulcus. Results showed that patients who received fat grafting with minimal or no skin release had better correction of jowls and fewer adverse effects than those who had ligament release without fat grafting (P = .046). The findings suggest that prejowl sulcus issues are more related to subdermal soft tissue atrophy than ligamentous contracture, and that fat grafting offers a more effective and safer solution. Surgeons are advised to consider volumetric fat grafting, potentially with subdermal release if necessary.