Fillers: Don’t Forget The Chin

Dr Paul Spano

Medical Director

SKINOVATE

Melbourne

www.skinovate.com.au

Indications

• Weak and aged chins • Cheek dominance

Chubby Cheeks

Strong Jaw Strong Jaw

Balance

A strong jawline is one of the most noticeable, and most attractive, facial features.

A well defined jaw gives the appearance of strength, confidence, and elegance, but only

if it is in harmony with the rest of the face.

 

Balance

Anatomy

Anatomy

• Collagen Bovine Porcine• Silicone Isolagen Fibril • Hyaluronics Generations• Polylactic Acid (Newfill)• Polyacrylamide (Aquamid)• Fat Transfer• HA, Calcium combos

Fillers

• Fat 1893 Neuber 1911 Injected Brunings

• Paraffin 1899 Gersuny• Fibrin 1957 Spangler• Silicone 1961 Uchida• Bovine Collagen 1977 Knapp Lock Daniels

FDA Approved 1981 Klein 1983 1000 pts• Hyaluranon 1965 (eye) 1988 (skin) Balazs• NASHA 1996

History of Fillers

• Informed consent• Good quality photos• Alcohol swab• Topical anaesthetic cream• Sitting up or almost• Mark out / Palpate Mental vessels / nerves

Chin Filling: 1

• Palpate the mental vessels• Mark out area to be filled • Needle perpendicular to skin• Feel needle touch bone• Inject just above bone (easiest layer to find)• Placing a PAD of filler on top of the bone• Push-up / lift effect (natural, lasts)• Natural look when deep

Chin Filling: 2

Add Superficial Filler

• To augment the deep filler• Mental crease• Intradermal• Subcutaneous

Relax Mentalis

• Overactive mentalis• Rule of Thirds• Overbite• Popply chin

Chin Filling: 3

• Volume 1 – 2 ml • Product eg Perlane, Sub Q or Modelis• Placement Supraperiosteal• Staging Can always add more• How Cannula vs Needle• Where At the edge of existing chin bulge

Chin Filling 4

• Learn from cheek / tear troughs • Above bone easy, reliable• Lasts longer ?? Hidden away from dermal enzymes• Surgical chin implants placed on bone

Superficial vs Deep

Deep Filling

• Widening of chin (less than width of mouth)• Protrusion of chin (less than nose tip)• Merge with pre jowel sulcus• Mental crease / fold• Marrionette folds• Will be different in almost every patient• BALANCE WITH CHEEKS

Chin Considerations

Protrusion

Protrusion & Width

• Before

• After

Camouflage with Beard

Protrusion

Before & After

Before & After

Before & After

Before & After

Before & After

Before & After

Before & After

Before & After

Before & After

Balance

Strength

Balance

Why Such A Long Face??

Great Chin!!!

Thank You

Dr Paul Spano

Medical Director

SKINOVATE

Melbourne

www.skinovate.com.au