Pre-jowl sulcus: the depression in front of the jowl
- Highlighted area
Quick facts
- Definition
- A depression in the jawline, just in front of the jowl and beside the chin.
- Location
- On the edge of the jaw, in line with the extension of the marionette line.
- Main cause
- Skin held to the bone by the mandibular ligament, with descent of the surrounding tissue and bone loss in the area.
- Neighboring structures
- Mental foramen, inferior labial artery and branches, marginal mandibular branch of the facial nerve.
- Relevance in HOF
- Breaks the continuity of the jawline and is a point of attention in jawline filler.
The pre-jowl sulcus is the depression on the edge of the jaw that sits just in front of the jowl and beside the chin. It appears because, at this point, the skin is held to the bone by the mandibular ligament, while the surrounding tissues descend with aging. The result is an interrupted jawline, with a step between the chin and the jowl, usually in line with the extension of the marionette line.
Why does the pre-jowl sulcus form?
| Factor | What happens |
|---|---|
| Mandibular ligament | Holds the skin to the bone at the front of the jaw and marks the fixed point |
| Fat descent | Fat above and behind the ligament descends and forms the jowl beside it |
| Bone loss | The mandible loses volume in its anterior region with age, deepening the step |
| Skin laxity | The skin loses firmness and follows the descent of the tissues |
| Muscles | The pull of the depressor anguli oris and the platysma accentuates the drop of the mouth corner and the region |
The sulcus is part of a set: low mouth corner, marionette lines, pre-jowl and jowl tend to progress together. That is why the jawline is assessed as one unit, from chin to angle.
Why does it matter in HOF?
- Jawline: softening the step can restore continuity to the jawline. The procedure is covered in jawline filler.
- Biostimulation: in some cases, the collagen biostimulator enters the lower third plan to improve tissue quality.
- Limit: when the jowl is large and sagging is marked, filling the sulcus may only widen the lower third. The assessment is covered in lower third laxity.
How does it show up in the assessment?
- Front and oblique photo: the three-quarter view shows the step between the chin and the jowl best.
- Head slightly tilted down: accentuates the jowl and the sulcus, revealing the degree of laxity.
- Lift test: when gently lifting the cheek skin, watch how much the sulcus diminishes. If it nearly disappears, the main cause is tissue descent.
- Palpation: bone loss in the anterior jaw, common in people without teeth, changes the planning.
The area is covered in jawline.
Also called: prejowl sulcus, pre-jowl depression, depression in front of the jowl.
Frequently asked questions
What is the pre-jowl sulcus?
It is the depression on the edge of the jaw that sits between the chin and the jowl. It appears because the skin is more tightly held to the bone at that point, while the surrounding tissues descend over time.
Can the pre-jowl sulcus be treated?
It can be softened, at the discretion of the qualified professional and after assessment, with approaches that restore support to the area, such as filler or a biostimulator. When sagging is significant, camouflage has limits and surgical options enter the conversation.