Shadows can from from the corners of the mouth, running down towards the jawline. These are often known as Marionette lines and tend to deepen with age. The natural loss of skin integrity and facial volume with age leads to a deepening of the folds. The folds form shadows around the mouth. These can make the face appear more sad, tired and older.

The visible line in front of the jowl that creates a visual demarcation between the mandible and chin often appears as an inferior extension of the nasolabial fold.