The Surgical Anatomy of the Jowl and the Mandibular Ligament Reassessed

• DOI: 10.1007/s00266-022-02996-3
• Publication Date: 2022-09-01T18:02:58Z
• Authors: Lennert Minelli; Hun-Mu Yang; Berend van der Lei; Bryan Mendelson
• Keywords: Aging; Adolescent; 610; LOWER FACE; Mandible; 03 medical and health sciences; 0302 clinical medicine; Face / anatomy & histology; 617; Platysma; Humans; Aged; RETAINING LIGAMENTS; LIFT; Ligaments; Labiomandibular fold; Mandible*; Superficial Musculoaponeurotic System*; Superficial Musculoaponeurotic System; Face; Jowl; Ligaments / anatomy & histology; Original Article; Facial retaining ligaments

A visible jowl is a reason patients consider lower facial rejuvenation surgery. The anatomical changes that lead to formation of the remain unclear. aim this study was elucidate anatomy jowl, mandibular ligament and labiomandibular crease, their relationship with marginal branch nerve.Forty-nine cadaver heads were studied (16 embalmed, 33 fresh, mean age 75 years). Following preliminary dissections macro-sectioning, series standardized layered performed, complemented by histology, sheet plastination micro-CT.The forms in subcutaneous layer where it overlies posterior part ligament. proper exists only deep, sub-platysma plane, formed combined muscular attachment mandible specific lip depressor muscles platysma. does not have definitive component. crease inferior oral commissure marks extent fixed dermal anguli oris.Jowls develop as consequence aging on functional adaptions mouth humans. To accommodate wide jaw opening narrowed requires hypermobility tissues overlying immediately lateral level commissure. This over occurs entirely allow move largely independent from skin. short, elastic connective tissue, which allows exceptional mobility without laxity youth, lengthens aging, resulting laxity. development redundancy constitutes location."This journal authors assign evidence each article. For full description these Evidence-Based Medicine ratings, please refer Table Contents or online Instructions Authors www.springer.com/00266 ."