In this section, we will discuss how physicians are using progressive medical techniques and advanced liquid face lift products, including dermal fillers such as Juvederm®, Radiesse® and Restylane®, as well as BOTOX®, to contour and correct deficiencies in the chin area, non-surgically.
Most commonly, experienced medical practitioners can correct a depression in an area on either side of the chin and immediately below the jowl line, known as the prejowl sulcus. Liquid face lift correction techniques can make a smoother contour between the jowls and chin, as well as lifting and diminishing jowls. Additionally, some physicians have developed techniques to augment a "weak" chin that has lost its prominence because of skeletal volume loss. Finally, a few doctors have developed methods to help (in some instances) with a chin that has become too prominent, occasionally referred to as the "witch" chin.
Prior to the procedure, most medical practitioners will numb the areas in which dermal fillers will be used with topical anesthetic, local anesthetic or nerve block. With an anesthetic, most patients are fairly comfortable during the procedure.
Note: Before undergoing any procedure discussed on this web site, make sure that your physician has extensive experience with the specific procedure. Medical schools have only recently begun to teach some of these procedures. As with any medical procedure there are varying degrees of risk involved. Please consult your physician.
The prejowl sulcus is a hollowing of an area on either side of the chin that is accentuated by the formation of jowls. This condition occurs in many individuals due to skeletal volume loss and facial atrophy, as part of the aging process. Jowls form as facial features begin to sag. Dermal fillers are used in a non surgical procedure by healthcare professionals in a couple ways to help with the prejowl sulcus.
The first method utilized by medical practitioners is to fill the sunken prejowl sulcus area with advanced dermal fillers or liquid face lift products, such as Radiesse®, Perlane® or Juvederm® Ultra Plus. The fillers are typically placed in the deep dermis below the skin in the recessed area between the jowl and the chin. If done properly, this procedure can restore a natural contour from cheek to chin in many individuals.
The second way to alleviate this condition is to lift the jowls with dermal fillers placed in the cheeks or along the jaw line. This may be done with advanced liquid face lift products such as Sculptra®, Juvederm® or Radiesse®. In some instances, physicians will use a combination of these products to optimize contouring and longevity of the results. With both of these techniques, the liquid facelift products are placed under the skin, primarily in the deep dermis (see Cheek Contouring).
In addition to the techniques mentioned above, some physicians will place BOTOX® in an area that is a little below and to the outside of the oral commissure lines (in the depressor anguli oris muscle) or along the jaw line, to help lift the corners of the mouth, which in turn can help with the prejowl sulcus.
Over time, the chins of some individuals lose their definition as skeletal recession and facial atrophy takes its toll. A weak chin may also be hereditary. A weak chin can play an important role in diminishing a person"s overall appearance.
Many physicians will recommend a surgical chin augmentation (mentoplasty) in individuals with an overly regressive chin. In 2007, over 18,000 surgical chin augmentation procedures were performed by plastic surgeons. This is down nearly 35% from 2000.1 For some individuals, the liquid face lift alternative may provide desired results without surgery.
If a receding chin is accompanied by jowls, then lifting the jowls will give the lower face better balance, diminishing the appearance of a weak or under formed chin. One method to subtly help the appearance of a weak chin is to use liquid face lift products such as Sculptra®, Juvederm® or Radiesse® on the areas of the cheek bones or sub malar region below the cheek bones on the flat plane of the face (see Cheek Contouring). This will add volume and gently lift the jowls up and away from the chin. Not only do the jowls become less prominent and less noticeable, but the chin appears to stand out more as a result.
Another method some physicians are using to augment a weak chin is to place either Radiesse® or bulking liquid face lift products, such as Juvederm® Ultra Plus or Perlane®, directly on the chin area. This method can help rebuild the prominence of the chin.
For persons considering a chin implant, one or both of these methods might provide enough noticeable improvement to forgo surgery.
In a few individuals, chins are overly prominent or seem out of proportion to the remainder of the face. This can be hereditary or may stem from hypertrophy of the mentalis (chin) muscle from over use.
If the individual with an overly prominent chin also has a sunken prejowl sulcus, then the techniques mentioned above (for correction of the prejowl sulcus area) will help contour and balance the chin with the rest of the face. This will diminish the appearance of a "witch" chin.
If overdevelopment of the mentalis chin muscle is a contributing factor, then some physicians will inject BOTOX® into the origin of the mentalis at the bottom (or tip) of the chin. This will decrease the forceful contraction of the muscle, which may somewhat soften or shrink the overdeveloped muscle, aiding in the reduction of the chin.
1Surgical Chin Augmentation Source: American Society of Plastic Surgeons
Advanced Dermatology PC of NY & NJ Commack, Commack, NY
Michael Macdonald MD FACS FRCSC, San Francisco, CA
Alexander Z. Rivkin, M.D., LA, Los Angeles, CA ~ Alexander Z. Rivkin M.D. Malibu, Malibu, CA
William J. Hall M.D., Scottsdale, AZ ~ Landon D. McLain MD, Huntsville, AL
Otto J. Placik MD FACS, Chicago, IL ~ Ramsey J. Choucair M.D., Dallas, TX