Quantitative Analysis of Age-Related Changes in the Lower Face

Lower facial aging is a dynamic process involving aging in the skin, fat compartments, and bony structures. Adopting appropriate methods to evaluate facial aging is important to clinical decision making. The aim of this study was to develop a method for evaluating lower facial aging pattern and to characterize age-related changes in the aging trajectory of the lower face using a combination of quantitative parameters.

A total of 200 subjects were stratified by age and sex into 10 subgroups for analysis. Lower facial aging features were evaluated using a comprehensive approach that included the Jowl Appearance Scale (JAS) for the jowl area; quantitative measurements for the marionette lines (marionette line length, maximum color depth, and marionette line angle between the horizontal axis); and the prejowl sulcus appearance scale for the prejowl sulcus triangle.

The JAS, the marionette lines grading scale, the marionette line length, the maximum color depth of marionette line, the marionette line angle, and the prejowl sulcus scale increased significantly with age for both male and female study populations. The correlation coefficients between age and the evaluated features were as follows: JAS (0.84), marionette line grading scale (0.81), marionette line length (0.86), maximum color depth (0.88), marionette line angle (0.90), and prejowl sulcus appearance scale (0.86).

The findings demonstrate a progressive pattern of lower facial aging that is effectively captured by the combination of quantitative parameters and the newly established prejowl sulcus appearance scale. This methodology provides a practical tool for developing personalized treatment strategies and facilitating timely interventions.

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