‘Keep your chin up.’ We've all heard the phrase, and, whether you realize it or not, the lower tip of your face actually plays a significant role in the harmony of all your other features. “Chin projection and shape are critical to facial attractiveness, as the chin is the foundational anchor of the face and enhancing projection brings the rest of your features into balance,” explains Anne Chapas, MD, a board certified dermatologist and medical director of Union Square Laser Dermatology in New York. “Historically, the chin has been neglected by patients, but women and men are beginning to realize the significance of the chin as the most prominent element of the lower third of the face.”
Whatever your desired final aesthetic may be, there are both surgical and non-surgical treatment options to augment and define the chin. Injectable fillers, for example, can offer a subtle enhancement, while surgical procedures will provide a more augmentative – and permanent – solution. From implants and injectables to submental fat reduction, here’s what you need to know about the top chin-defining treatments.
Surgical Chin Augmentation
“Choosing whether to have non-surgical or surgical chin enhancement depends on your facial features, the condition of your skin, and your medical history,” explains Cheryl Karcher, MD, a board certified dermatologist and medical director of Center Aesthetic Dermatology in NYC. As in most cases, surgical chin augmentation offers a more permanent solution than its minimally invasive counterparts. Surgical solutions include:
Mentoplasty (a.k.a. chin augmentation) is the process of surgically placing an implant into the lower half of the face to help it protrude, permanently. According to Philip J. Miller, MD, a double board certified facial plastic and reconstructive surgeon at Gotham Plastic Surgery in NYC, the surgery is “easy, quick, and done under local anesthesia.” During the procedure, which requires an incision to be made under the chin to place the implant, the patient may “feel some pressure.” The most common type of chin implant is an alloplastic implant. It can be molded by the provider to create the necessary shape for each individual.
To complement the definition created by the chin implant, Dr. Miller often recommends patients combine the procedure with NeckTite™, a minimally invasive treatment that employs radiofrequency to remove excess submental fat and tighten the skin under the chin. While it will take about three months to fully enjoy the results of a chin implant surgery, any post-op swelling and bruising should resolve in about a week.
For patients with a weak chin due to structural deformity, osseous (or sliding) genioplasty may be needed. More complex than mentoplasty, the surgery involves incisions inside the lower lip to reach the mandible (read: lower jaw bone). The lower jaw is cut and repositioned, and screws and plates are inserted to reattach the jaw. Recovery is slower, with final results taking 12 to 18 months. To enhance the results of the osseous genioplasty, dermal filler (more on that below!), fat transfer, and even rhinoplasty may be recommended.
Due to the more invasive nature of this surgery, candidates usually have a bone structure deformity. “A candidate should be in overall good health and have realistic expectations,” Dr. Karcher says. “Usually, chin enhancement is considered cosmetic and not covered by insurance. However, if there’s a structural defect, insurance may cover it.”
Chin Implant Revision
For those unhappy with the results of a previous chin augmentation, the implant can be removed — but it may require additional procedures. The surgical correction of chin ptosis (read: drooping) as a result of aging, genetics, or implant removal can remove excess skin and tighten sagging tissue. The bone is not impacted. Performed under local anesthesia, the procedure has about seven to 10 days of swelling and bruising. Results are immediate, though recovery takes about a month.
Non-Surgical Chin Augmentation
But surgery isn’t the only option for those looking to enhance the chin. Injectables like dermal filler and Kybella® can be used to slim, define, and augment the submental area, and the recent approval of Restylane® Defyne by the United States Food and Drug Administration (FDA) for chin augmentation and the correction of mild to moderate chin retrusion has put a fresh focus on non-surgical chin enhancement solutions.
Hyaluronic Acid-Based Filler
In February, Restylane® Defyne became the first FDA-approved chin filler to demonstrate results across a wide range of patients, including all skin types, male subjects, and subjects over the age of 52. “The studies have shown high satisfaction data, with more than 99 percent of patients and 100 percent of injectors reporting improved appearance of chin projection 12 weeks after treatment,” explains Dr. Chapas, who served as an investigator in clinical trials of Restylane® Defyne for the chin. What’s more? “Most patients had significantly improved chin projection (86 percent when asked at 12 weeks) for up to one year (74 percent at one year) compared to no treatment,” she adds.
As with most HA fillers, mild swelling and bruising may occur for about a week after a Restylane® Defyne injections, but Dr. Chapas has found that patients require “little to no downtime.” She tells patients to “avoid irritating or manipulating the treated area and refrain from exercise and alcohol for 24 hours following treatment.” Dr. Karcher notes that patients often like HA filler (of any kind) “because they can be reversed if there’s ever a problem.” Her picks? Restylane®, Juvéderm® Voluma, and Revanesse® Versa.
For patients who aren’t interested in surgery but want more permanent definition, collagen-building fillers can provide longer lasting results. Instead of simply adding volume, calcium hydroxylapatite (CaHA) fillers like Radiesse® and poly-L-lactic acid (PLLA) fillers like Sculptra® stimulate collagen production to naturally fill the treatment area even after the product breaks down. Unlike HA fillers, which are dissolvable with hyaluronidase, these CaHA and PLLA fillers are not reversible.
Dr. Karcher recommends discussing your aesthetic goals with your provider to determine which filler is best for you. “The filler chosen for you would depend on your needs,” she says. “How much of the filler do you need? Have you ever had filler before? Do you want something permanent? Do you want something that can be reversed if you don’t like it? How long do you want the filler to last?”
If your concerns involve a double chin, there is another type of injectable to consider. Kybella® (a.k.a. deoxycholic acid) is an FDA-approved fat-burning injectable that reduces submental fat to slim the neck and enhance the profile of the face. You can use Kybella® to “dissolve the fat under the chin, therefore making the chin appear more pronounced,” Dr. Miller explains. The fat reduction caused by deoxycholic acid injections is permanent, though it takes about six weeks to see results. A series of treatments may be necessary for best results.
Depending on your aesthetic goals, both temporary and permanent chin enhancement is possible to improve the protrusion and definition of the lower face. Because the chin plays such an important role in the overall proportion of the face, complementary procedures may be recommended to maximize results. Consulting with a board certified dermatologist or plastic surgeon will ensure you receive the best treatment for your needs.
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