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Can I get fillers in the prejowl sulcus area and not the marionette lines? (Photo)

I have both, but its really just the pronounced indentation between my chin and jowl that bothers me. If I could just get my jawline smoothed out a little, I'd be happy. But was wondering if that would look strange. Also wondering how much filler it would take to correct the prejowl sulcus - would one syringe of Radiesse be enough?

Doctor Answers (13)

Filling prejowl sulcus can be done alone, probably in your case you will need more than 1 syringe

+2
Sure, the prejowls sulcus can be filled along the jawline with Radiesse.  I think about 2 syringes would be good.  Putting some in the chin area will also help everything because your chin has lost projection and contributing to the sulcus.  I like cannulas for this area, a lot less bruising. 


Panama City Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

Treatment of prejowl sulcus

+2
Thank you for your picture and question. Treatment with dermal fillers shows an immediate result. You would be an excellent candidate to have your prejowl sulcus filled with a dermal filler. If the marionette line is still bothersome after the prejowl area is treated, have the injector treat the marionette lines.

I hope this helps.

- Bryson G. Richards, MD

Bryson G. Richards, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 8 reviews

Can I get fillers in the prejowl sulcus area and not the marionette lines?

+1
You can, but I would be very careful about injecting too much filler in the prejowl sulcus!  A squared off boxy jaw is a masculine feature and could put you in a state of facial disharmony.  A youthful face is more full in the upper/mid face.  It's best to be evaluated by an experienced "core" injector (facial plastic surgeon, plastic surgeon, dermatologist, or occuloplastic surgeon). This is because we all have a keen understanding of facial anatomy and the effects of injecting fillers in different regions of the face. If you see a facial plastic surgeon or a plastic surgeon, you can hear about your surgical options as well. I wish you well!

Parker Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

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Radiesse for the jaw line

+1
Radiesse is my favorite filler for smoothing the indentation along the jaw line between the chin and the jowl. Typically one syringe is enough which appears to be the case when looking at your picture. The results are subtle and very nice. If more smoothing is desirable, a small amount of Radiesse placed further back at the angle of the jaw can have a lifting effect and give an even nicer improvement.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Can I get fillers in the prejowl sulcus area?

+1
Fillers are a great option for some patients with hollowing in front of the jowls but you need to be careful to not alter youthful facial harmony by having too much volume added and thereby making the lower face appear too heavy and the face look too square. The hyaluronic acid fillers such as the Juvederm family are excellent choices due to their wide safety margin and their ability to be "erased" if you don't like the result. Lastly, if your prejowl sulcus is due to facial skin laxity it might be time to consider a surgical solution. Best wishes.

Kevin L. Smith, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 10 reviews

Radiesse for prejowl sulcus

+1
Dear Newme2,

Radiesse is a great option for pre-jowl sulcus. The pre-jowl sulcus makes your face/chin longer, and sometimes accentuates your jowls. For many patients, Radiesse filler is a great option to create a smoother transition along your jawline. I would have a qualified physician inject along these areas as facial artery and nerve are close by.  A 1.5cc syringe should do the trick.

Kyle S. Choe, MD
Virginia Beach Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

Prejowl Injection

+1
Hello newme2, 

Thanks for the question and photo. 

Without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of any treatments it is difficult to be comprehensive.

I think injection with Radiesse 1.5 cc syringe is a reasonable starting point.  

Ultimately the long term surgical option would be a face lift to help elevate the jowl and with your anatomical findings on this photo, you could also consider a permanent pre-jowl implant so you could avoid future injections. 

Good luck ,

Dr. Shadfar

Scott Shadfar, MD
Indianapolis Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Fillers to Prejowl and Marionette

+1
You are a great candidate for fillers but would need a formal evaluation to see how much skin laxity and graviational changes you have in your jowl and cheeks.  It maybe that you need more formal 3D contouring with fillers to lift the cheek and preauricular (near ear) areas that will help lift and shape rather than just "fill" the areas you are dicussing.  I sugggest seeking a formal evaluation with a dermatologist or plastic surgeon who is very experience in fillers and facial contouring.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 44 reviews

The pre jowl sulcus and marionette line is one congruent area.

+1
Hello.  If you want filler along your mandibular sulcus only, this can be done.  It will have to be tapered into your marionette line to some degree.  The filler does not have to be placed all the way up to your corner of your mouth.  In that case, 1.5 cc of Radiesse will most likely be sufficient.  Typically however, I consider the pre-jowl depression a result of the marionette line.  Correcting the pre-jowl sulcus is a correction of the lower most portion of the marrionette line.  You should consider the marrionette line and pre-jowl sulcus as one area and not independent of one another.  Therefore, when you fill the pre-jowl sulcus you are effectively filling the lower portion of the marrionette line.  The goal is to create a smooth transition within this area.  Your picture is a bit grainy.  Radiesse comes in 0.8 cc and 1.5 cc volumes.  1.5 cc spread between the two sides should be enough for just the mandibular groove (pre-jowl sulcus).  However, to correct the "unit" (the entire area, what you separate as the pre-jowl gooove and marrionatte line) will most likely require more than 1.5cc of Radiesse.  You can start with a 1.5cc syringe and wait 2-4 weeks to determine if you are satisfied.  If after this time, assuming the filler was injected well, and you are not satissfied with a less than total correction, you can have another syringe injected. I like radiesse in this area.  It has proven to be a good filler in this region.   

Ryan Mitchell, DO, FAOCO
Henderson Facial Plastic Surgeon

Fillers for the Prejowl Sulcus

+1
Certainly you can have a filler to fill the prejowl sulcus and not the marionette lines, your choice. A filler would fill in the prejowl sulcus nicely. Ideally, a more formal correction of the problem is best. However in the meantime you can certainly soften the appearance with a filler. It is not permanent, and you would likely be pleased if not over done. There are a number of fillers available including juvederm, voluma, restylane, radiesse, perlane, etc. It would probably require one cc on each side for the hyaluronic acid fillers and perhaps only one syringe of radiesse.

Sam Gershenbaum, DO
Miami Plastic Surgeon
4.5 out of 5 stars 25 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.