Is a pre jowl implant a good idea for a dark area? (photo)

Question

I've had this dark bruise like area for years (never injured). I've had filler there AND fat grafting with minimal improvement. Would a pre-jowl implant be a good idea for this or would it change the shape of my face too much?

Eric M. Joseph, MD · Answer

Based on your limited photos, I would not recommend an extended implant to camouflage your tiny prejowl sulcus. Clear why there is a bluish discoloration to the skin. This could be from ha filler injected superficially. We have had excellent success in camouflaging these, permanently, with microdroplet Silikon-1000 injections.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear Liftweightseatcake,

I love your username! Plain and simple I would not put an implant in that area. I understand that this area is disturbing to you, but I don't think we have a proven plastic surgery procedure that would improve this predictively. It may be cover-up make up techniques as a solution to camouflage this area.

Best wishes,

Earl Stephenson, JR., MD, DDS, MBA 
ESJ Aesthetics

Lucian Ion, FRCS · Answer

Thank you for sharing your photographs and your question. The depression in the pre-jowl region—and how it changes when you smile—suggests that the mandibular ligament on the left side might be playing a role. This issue could potentially be addressed with a combination of subcision and micro-fat grafting, and possibly even nano-fat grafting.

Determining the exact cause can be challenging without an in-person consultation. During an in-person visit, one approach to confirming the ligament’s role is to inject a small amount of saline under the depressed area. If the depression doesn’t fill as expected and the saline moves around, it suggests that the mandibular ligament is holding it down. In that case, releasing the ligament might improve the flexibility and movement of the skin, thereby reducing the tethered appearance.

Zoran Potparic, MD · Answer

Your deformity seems to be very mild and I am surprised that injection of filler did not correct it? Only on the basis of in person evaluation an experienced board certified plastic surgeon with reputation in facial rejuvenation would be able to decide whether implant augmentation would correct  this permanently.

Is a pre jowl implant a good idea for a dark area? (photo)

Answers (4)

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