It seems like it was a bit of both, and yes it does have an aging effect. If you are consulting for jaw surgery, I would ask them if they use the V-Y closure technique.Thanks for the explanation and examples. I have seen these pics before and noticed the area getting fuller but just imagined it was coming from the advancement of underlying bones pushing the soft tissues forward. In your experience, does the soft tissue sagging mean that the soft tissues just bulge out or actually drop downwards? If the latter it sounds like this could have an ageing effect on the face.