CMF Cranio-Maxillofacial Surgery Associates

The use of dermal Fillers for Genioplasty


I am frequently asked if a filler can be used to augment the chin, and it certainly can be. The issue is that it typically lasts for only a few weeks to months unless a semi-permanent filler like Radiesse is used. The reason for its quick elimination is that the chin has a lot of muscle action that directly puts pressure on the filler. The muscle pressure will cause the filler to dissolve, or worse, to migrate asymmetrically. A dermal filler is normally a superficial injection near the skin surface, but in the chin, it has to be below the muscle but on top of the bone. This is like putting a lot of jam between two pieces of bread and squishing it-it’s not going to stay where you put it. There are a couple of reasons why providers will recommend chin augmentation with filler.

First is more cost-effective in the short term to do it with a filler; there is no surgical fee, no sedation needed, and relatively speaking a syringe or two of filler is far cheaper than an implant or genioplasty. Second, most providers who do chin augmentation with fillers don’t have the ability to put in an implant, yet they may not want to tell you that. The problem with having a diverse population of providers who can do injectables is that it becomes competitive and marketing is often more effective than doing good work. When you are considering any aesthetic treatment, it is essential to know all of the options; surgical, non-surgical, injection, or otherwise.

At CMF, we encourage you to ask questions and make sure we understand your goals, your history, and when presented with the options we will help you pick the best treatment.

 

Timothy M Osborn, MD, DDS, FACS
Physician/Surgeon
C.M.F.-Cranio-Maxillofacial Surgery Associates
366 Broadway Ste 100
Somerville, MA 02145
617-628-8000

Use of dermal fillers for Genioplasty

We are frequently asked if a filler can be used to augment the chin, and it certainly can be. The issue is that it typically lasts for only a few weeks to months unless a semi-permanent filler like Radiesse is used. The reason for its quick elimination is that the chin has a lot of muscle action that directly puts pressure on the filler. The muscle pressure will cause the filler to dissolve, or worse, to migrate asymmetrically. A dermal filler is normally a superficial injection near the skin surface, but in the chin, it has to be below the muscle but on top of the bone. This is like putting a lot of jam between two pieces of bread and squishing it-it’s not going to stay where you put it.

There are a couple of reasons why providers will recommend chin augmentation with filler.

First is more cost-effective in the short term to do it with a filler; there is no surgical fee, no sedation needed, and relatively speaking a syringe or two of filler is far cheaper than an implant or genioplasty.

Second, most providers who do chin augmentation with fillers don’t have the ability to put in an implant, yet they may not want to tell you that. The problem with having a diverse population of providers who can do injectables is that it becomes competitive and marketing is often more effective than doing good work.

When you are considering any aesthetic treatment, it is essential to know all of the options; surgical, non-surgical, injection, or otherwise. At CMF, we encourage you to ask questions and make sure we understand your goals, your history, and when presented with the options we will help you pick the best treatment.

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Genioplasty or Chin Augmentation?

Why Genioplasty?

 

Not being happy with the appearance of your chin or jawline is common and I often hear my chin is “too strong” or “not there.” It may not be noticeable when looking from the front, but people often notice it in pictures or posts. Our eyes pick up balance or the lack thereof, and it can be hard to define. Knowing when a chin is in balance is the art of surgery and requires a surgeon experienced in facial aesthetic surgery, surgery of the jaws, and nasal surgery with the ability to understand the balance of facial proportions.

Here are some easy ways to evaluate the position of your chin on your own.

-As you look at a profile picture of yourself and your chin protrudes beyond your forehead, it may be excessive.

-If the distance from your lower lip to your chin is more than 2x greater than from under your nose to your upper lip, you may have vertical excess of your chin.

-If the chin looks rounded

-If you have dimples in your chin when closing your lips, you may have a deficient chin

-When you take a picture, if you tip your chin up or back, you may be masking its true position. When you take a picture, put yourself in a “natural head position.” The best way to do this is to close your eyes, rotate your head side-to-side, and look straight ahead when you open your eyes.

-As you look at the picture, if your chin is behind or ahead of the prominence of your forehead, you may benefit from an evaluation by one of our craniofacial surgeons.

Genioplasty specifically indicates that the surgeon is reshaping the bone of the chin, whereas the use of an implant or filler is chin augmentation. There are 2 general types of genioplasty; reduction and augmentation. Reduction genioplasty is done to soften the contours of the chin to harmonize with the face typically horizontally, in width, and vertically. What is generally referred to as a “sliding genioplasty” is a horizontal movement of the chin to increase the prominence.

 

Genioplasty or Chin Augmentation?

Genioplasty is best when:

-Less than 30y of age

-When a horizontal and vertical increase is needed, or any asymmetry correction is planned

-Avoidance of an external scar

-When a V-shaped or narrow chin is desired

-When there is chin dimpling when the lips are closed

-When undergoing general anesthesia for rhinoplasty or jaw surgery

-When any reduction of the chin is needed, or jawline contouring is to be performed

Chin augmentation is best when:

-Liposuction or neck lift is being performed at the time of augmentation

-When a broader (wider) chin is desired

-When the patient would like sedation in the office (rather than hospital/surgery center)

-When only a small augmentation is needed (5mm or less)

 

Dr. Timothy Osborn “In my experience, the 2 main deciding factors for genioplasty vs implant is if the patient would like to do the procedure in-office or a small correction is needed, both of which favor an implant. We are going to assess your goals, and help you decide which option is best for you”.

 

Do I need chin surgery or jaw surgery?

One of the critical reasons to see a CMF surgeon when evaluating your chin is that we are highly skilled at determining if it is weakness or excess in your entire jaw or just your chin by evaluating how your teeth come together. We work very closely with an orthodontist to evaluate if any treatment of the teeth is needed to bring further balance and harmony to the chin and face. A normal and functional bite should be balanced all the way across. Some ways for you to be able to tell if you may benefit from an orthodontic evaluation:

-If your top and bottom teeth don’t touch

-If your top teeth are behind your bottom teeth (underbite)

-If your bottom teeth are far behind your top teeth (overbite)

-If you only bite on your back OR front teeth

-If you bite harder on one side compared to the other

 

Especially when we are dealing with a global pandemic, it is easy to get focused on health as the only relative to life or death. But health is more than things that threaten us, it involves feeling well and our systems working at their peak efficiency. I see a lot of patients with nearly non-functional bites and they may have no idea that it could be better. Just because we have lived with something for a long time and are “doing OK” with it, doesn’t mean that it can’t be improved. Looking and feeling your best is not selfish or vain and you deserve it.

 

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