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

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.   

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!

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.

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.

Yes, pro jowl filler to the pre jowl area will soften this depression. Make sure it is not overdone. Eventually you will have to have a facelift since the skin is dropping below the jaw bone.

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

Hello.  Filler to the labio-mandibular line (prejowl sulcus) is a reasonable course.  Options include Radiesse (calcium based) as well as Juvederm (hyaluronic).  Select a surgeon whom you feel comfortable with, one who answers all your questions to your satisfaction and is able to show you multiple before and after photos of patients with concerns similar to yours.Hope this is helpful.  Best wishes.  Dr. Shah

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.

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

From your photos it appears that you would be a good candidate, but I would make an appointment with an experienced injector to confirm in person.  I love this procedure and place the filler on the bone with a needle or cannula.  Try to stop blood thinning medications 10 days before unless prescribed by a doctor (if prescribed, you need to discuss with your prescribing doctor how to proceed).  This area tends to bruise more than other areas.  I think 2 syringes would be more appropriate from your photos.  I would use Voluma or Radiesse.