Can Filler Shape a Woman's Chin Without an Implant?

All right, this is like a live video. This is my staff. So [our medical aesthetician] wanted to have a more chiseled chin. She's perfect, everybody would agree, but she wants to have more definition.

Now, here's the thing with the chin and women. Chin implants, on this view, look really good. On this view, they sometimes make a woman look kind of boxy or too square or even round. I don't like it. Sometimes it's a necessary evil, especially with a deep plane facelift. If the chin is weak, you have to do it, but there's a trade-off.

Now here, with fillers, we have more options. I can take the central chin and project it out, create a more chiseled look without that square look that a chin implant would do. That's all I'm going to do. So her head is back. She's going to be upright. She's not going to be lying down. She's going to be in this position.

We're going to also be able to correct some asymmetries with fillers. Nobody's symmetric. The midline of the chin, the midline of the upper lip, lower lip, eyes, they're all in different midlines. And typically one side of the chin is a little bit more projected, a little bit lower. So with fillers, if you do the injections asymmetrically, you can make the chin more symmetric. With a chin implant, it's harder to do that. You actually may accentuate asymmetries.

I'm using a hyaluronic acid. We're going to use a very, very small needle. Thoroughly alcohol. Perfect. Now, what I typically do is I hand my patients the mirror so they can see and point to the things. We'll see it together.

All right, so when you go central... I don't know if you saw what she just did. She's pulling her chin up. Her mentalis is pulling the chin up. So at some point we may actually want to do like five, ten units of Botox to relax the chin, but right now we're just going to focus on this.

Relax the chin. Open your lips. Now, when you do this injection, because the mentalis kicks in and just wants to lift the chin upwards, you always have them open their mouth. Leave the teeth open. You want to have at least half a centimeter of space between the teeth, not too far open, but you don't want them together, because as soon as they put their teeth together and put their lips together, if their mentalis and their musculature is strong, it'll pull the chin up. We don't want that to happen. So leave it right there.

Now, you guys know for 25 years I've been talking about the micro-droplet technique, right? Tiny little drops. This is not micro-droplet. This is an area where you basically go right down to the bone and you fill it to the effect that you want, almost like a chin implant. This is not micro-drop. But don't go in and out a million times, and you've got to be in the right plane. Like this. It feels weird, right?

Patient: I was going to say, it feels like a bag of worms.

She did not numb for this. But look how tiny that needle is. This filler, RHA 4, comes with a 27 gauge needle. I switch it to a 31. It makes it much more comfortable.

So I look at this level, I'm also looking at this level, and you can see I'm keeping a midline, right? Sometimes you have to taper it into the pre-jowl sulcus. Sometimes you have to come up to the marionettes. But for her, it's really just focusing on the central portion. I'm looking at the center of her lower lip and her chin. They're on two different planes, so I'm going to inject it in a way to make sure that it's more symmetric, not less symmetric. Almost there.

All right, take a look. There. And there's no square. We got more projection, a little more pointiness right there. Cool.

Patient: Love it. It looks really good.