Chin augmentation is another very commonly requested aesthetic procedure in Asian patients, who genetically tend to have shorter, recessed chins – which if you picture it, is similar to that of a baby or a young child. It is no wonder then that several cultures associate the appearance of a short chin with someone who is less intelligent, or more innocent and gullible. Scientifically, the most ideal facial proportion is thought to be equal thirds from the hairline to the eyebrows, the eyebrows to the nose tip, and the nose tip to the chin apex. While it is unrealistic and often unsatisfactory to pursue exactly equal thirds in every face, a short chin can significantly shorten the lower third of the face compared to the upper and middle thirds, making the face appear short or unbalanced. In the side view, the ideal proportion is thought to be where the tip of the nose, the lips and the chin form a continuous line that contours the lower face. In turn, a short and especially recessed chin draws that line backwards, giving rise to an undesirable aesthetic of the lower face. Anatomically, a short or receding chin does not offer structure for the surrounding skin to drape over, which can lead to a poorly defined jawline, a lack of transition between face and neck, and the appearance of a loose or “double” chin. In some patients, the small muscles of facial expression around the chin can become stronger than usual to compensate for the lack of structural support to the lower teeth, leading to the appearance of a wrinkly “cobblestone” chin, or a sad look due to downturned lip corners.
Chin fillers is therefore one of the most commonly performed aesthetic treatments in Asia, as it can help improve facial proportions both in the front and side views, provide contour to the lower face, and help the patient appear slimmer and more attractive. It can provide definition to the jawline and a clear demarcation between face and neck, while reducing the appearance of loose skin or “double” chin, helping the patient look sharper and more sculpted. Finally, well placed chin fillers can provide structural support to the lower teeth, relieving the surrounding muscles from that job that they were not meant to do, which naturally relaxes the area and reduces the appearance of harsh lines and folds around the mouth in expression, and can even improve “overbite” (where the upper and lower teeth don’t meet perfectly upon chewing) or downturned lip corners in affected patients.
It is imperative to understand however that chin augmentation must be done for the chin as a whole, and not just to lengthen a single point in the middle. If we injected a large amount of filler only in the apex of the chin, it could lead to a chin that appears unnaturally long, sharp, and pointy, or a so called “witches’ chin”. At the same time, in older patients with significant elements of sagginess and broadening of the lower face, it is important to first lift the midface and cheeks before treating the chin and jawline, as the restored support to the lower face will already improve the appearance of the chin and overall facial proportions before any fillers are injected in the chin, reducing the amount of fillers required to adequately treat the lower face, as well as enhancing the results of the chin augmentation.
Finally, using fillers that are specifically designed for chin augmentation can often help an injector more efficiently achieve good results and patient satisfaction. In our clinic, we use Juvederm Volux, a strong and robust filler that for me achieves the fine balance between providing significant projection per volume, an ability to retain it’s shape in a highly mobile area, and longevity of results (as opposed to softer fillers or collagen stimulators); while remaining a gel (part solid, part fluid) that has good tissue integration, and moves naturally with chewing and facial expression (as opposed to a solid surgical implant).