Assessing the Lower Face: Lips, Chin, and Jawline. 2025

Kavita Mariwalla, and Sabrina Fabi, and Daniel Belkin, and José R Montes, and Rebecca Fitzgerald, and Amelia Hausauer, and Wendy Lee, and Charles Boyd, and Shilpi Khetarpal, and Breanna Pasko Jernigan
Mariwalla Dermatology, Long Island, New York.

BACKGROUND The lower face, including the lips, chin, and jawline, plays a defining role in facial proportion and expression. Aging of this region involves a complex interplay of skeletal remodeling, soft tissue descent, and muscle hyperactivity, which manifest differently across ethnic groups and influence aesthetic ideals. OBJECTIVE To describe structural and cultural variations in lower-face anatomy and aging, and to outline evidence-based strategies for individualized, ethnically sensitive rejuvenation. METHODS A multidisciplinary group of dermatologists, oculoplastic, and plastic surgeons synthesized anthropometric data, global literature, and clinical experience to analyze lower-face morphology, ethnic aging patterns, and patient priorities. RESULTS Distinct lower-face characteristics and aging trajectories were observed among diverse populations. While perioral atrophy and rhytids dominate in patients of European descent, chin retrusion and jawline heaviness are common in East and South Asian groups, and pigmentation changes frequently accompany aging in richly pigmented skin. Noninvasive techniques, including hyaluronic acid fillers, poly-l-lactic acid biostimulators, and neuromodulators, offer effective options for reshaping, volumizing, and contour refinement. CONCLUSIONS Lower-face rejuvenation requires both technical precision and cultural awareness. Tailoring treatment to ethnic morphology and evolving aesthetic ideals supports natural, authentic outcomes aligned with patients' self-perception and heritage.

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