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2. Fillers: Don’t Forget The Chin
Dr Paul Spano
Medical Director
SKINOVATE
Melbourne
www.skinovate.com.au

3. Indications
• Weak and aged chins • Cheek dominance

4. Chubby Cheeks

5. Balance
Strong Jaw Strong Jaw

6. 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.

7. Anatomy

8. Anatomy

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

10. History of 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

11. Chin Filling: 1
• Informed consent
• Good quality photos
• Alcohol swab
• Topical anaesthetic cream
• Sitting up or almost
• Mark out / Palpate Mental vessels / nerves

12. Chin Filling: 2
• 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

13. Chin Filling: 3
Add Superficial Filler Relax Mentalis
• To augment the deep filler • Overactive mentalis
• Mental crease • Rule of Thirds
• Intradermal • Overbite
• Subcutaneous • Popply chin

14. Chin Filling 4
• 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

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

16. Deep Filling

17. Chin Considerations
• 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

18. Protrusion

19. Protrusion & Width
• Before
• After

20. Camouflage with Beard

21. Protrusion

23. Before & After

24. Before & After

25. Before & After

26. Before & After

27. Before & After

28. Before & After

29. Before & After

30. Before & After

31. Before & After

32. Balance

33. Strength

34. Balance

35. Why Such A Long Face??

36. Great Chin!!!

37. Thank You
Dr Paul Spano
Medical Director
SKINOVATE
Melbourne
www.skinovate.com.au