How Can Men Get a More Chiseled Jawline with Filler?

So we have an attractive young man who wants to have a very chiseled type of face. We've known each other for a few years now, and we have been working on his cheeks. I'm not a fan of doing too much in one shot, so a little bit at a time. We've created really nice, defined, chiseled cheekbones for him. Today we're going to add a little bit to the jawline to augment that and give him that really nice, chiseled, defined face, plus a couple of spot treatments in other places. We're using Voluma here.

I always tell patients that when we do this area, there's always a risk of issues with the parotid gland. There's a risk of infection and fistula formation. We prep the face fully, but there's really no way of making anything on the face completely sterile, even surgically, because the mouth and nose are around that area. Luckily, the face has good blood flow, good vascularity, and infections are very rare, but it's something to be aware of.

My technique is usually serial puncture with micro droplets. Here, these are going to be slightly larger droplets, because you need more volume there. But I don't like serial threading, because I don't want stuff just underneath the skin. It doesn't make sense to have filler from a long needle or a cannula underneath the skin here. This needs to be on top of the bone, on top of the muscle, pushing it out. The injections are deep, and then they basically fill out, and it's just creating more definition to the angle of the mandible, to the ramus. If you need a break, let me know.

The filler is Voluma, and the Voluma has lidocaine in it. There are angle-of-mandible implants, but again, it's a risky procedure in this area. There's a risk of nerve damage. The filler is a better option.

Now, the grass is always greener on the other side. There are plenty of patients who have very full mandibles. They don't like it, so they come in and we do Botox to basically the same exact area, to thin out and cause atrophy of their masseter muscle. A lot of women come in asking for a more defined jawline. While you can get the definition from the profile, you have to be aware that it also gives you more width from the front view. For men, it's a nice look. For women, you have to balance the front and the side together. You don't want to have a very defined side view and then a very wide front view.

So these are serial injections, building little columns. It defines the jaw nicely. I'm going to walk it up the ramus of the mandible. Anytime you add volume to the face, you're also improving skin laxity. As we get older, we lose some volume and the skin loosens up a little bit, but as we do this, it basically fills out the skin nicely.

The massaging is very gentle. I'm putting the filler where it needs to go. I'm not overfilling any area, so I don't need to sit there and beat up the face and massage it too much afterwards. So that's one cc. If you back up a little bit, you can see this area compared to where we started. No bruising at all. A little bit of swelling.

Now, one syringe of filler is only one-fifth of a teaspoon. In the FDA trials, for example, for the midface, they were doing seven to fourteen syringes of filler. We've never done more than a couple at a time. I'm more a fan of doing a little to build it up, but not so little that they don't see a difference. So we're going to add a couple more syringes, and then in about four to six months, we'll add a little bit more. So that's basically defining the angle of the mandible, and it's a pretty common procedure among men today, and some women.