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Background: Aging of the face occur in a variety of ways and ultimately affects every facial structure. But not every facial structure is affected equally or at the same time. While it is true that the very earliest signs of facial aging occur around the eyes, changes along the jawline and neck are often not that far behind.

Jawline aging first presents as the appearance of jowling. These are subtle changes along a once more defined jawline with soft tissue bulges behind the chin. This being the loss of a smooth jawline between the chin and jaw angles. This loss is magnified and its severity is greater if the chin is genetically short and the jaw angles weak or ill-defined. People with naturally stronger jawlines and chins better resist these aging changes or at least defer their appearance due to the larger  skeletal support for the soft tissues.

The onset of jowls and early facial aging has been a target of many types of non-surgical therapies. Various skin tightening devices/technologies and injectable fat reduction methods strive to reduce their appearance. While all non-surgical treatment approaches have some positive benefits, their roles is defined as an offering that avoids surgery and any of its associated recovery albeit with a far less effective change.

Case Study:  This young middle-aged female was bothered by the slow and persistent onset of jowls. A bulge had appeared between her somewhat shorter chin and higher jaw angles. Her lower face was somewhat shorter or smaller than the rest of her face.

Under general anesthesia a jowl tuck-up procedure was performed (limited facelift or mini-facelift) combined with a small chin implant placed though a submental skin incision.

Her early one month result shows the resultant smoother jawline and more shapely lower face. (not as heavy or facial triangle inversion)

Reversing the presence of jowls is helped most significantly by relocating the fallen soft tissues that have occurred over it. But extending the skeletal length of the jawline by chin augmentation has a complementary role in such jawline enhancements.

Case Highlights:

1) Early signs of facial aging occur along the jawline as jowls and lack of a sharp linear jawline.

2) Losing the shape of a jawline with aging is magnified in the presence of a shorter chin.

3) The diametric movements of moving the soft tissues backwards and the hard tissue of the chin forward creates a better defined jawline then either one alone.

Dr. Barry Eppley

Indianapolis, Indiana

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