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Filler Chin

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Filler Chin

  1. 1. Fillers: Don’t Forget The Chin Dr Paul Spano Medical Director SKINOVATE Melbourne www.skinovate.com.au
  2. 2. Indications• Weak and aged chins • Cheek dominance
  3. 3. Chubby Cheeks
  4. 4. BalanceStrong Jaw Strong Jaw
  5. 5. BalanceA strong jawline is one of the most noticeable, and most attractive, facial features. A well defined jaw gives the appearance ofstrength, confidence, and elegance, but only if it is in harmony with the rest of the face.
  6. 6. Anatomy
  7. 7. Anatomy
  8. 8. Fillers• Collagen Bovine Porcine• Silicone Isolagen Fibril• Hyaluronics Generations• Polylactic Acid (Newfill)• Polyacrylamide (Aquamid)• Fat Transfer• HA, Calcium combos
  9. 9. 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
  10. 10. Chin Filling: 1• Informed consent• Good quality photos• Alcohol swab• Topical anaesthetic cream• Sitting up or almost• Mark out / Palpate Mental vessels / nerves
  11. 11. 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
  12. 12. Chin Filling: 3Add Superficial Filler Relax Mentalis• To augment the deep filler • Overactive mentalis• Mental crease • Rule of Thirds• Intradermal • Overbite• Subcutaneous • Popply chin
  13. 13. 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
  14. 14. 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
  15. 15. Deep Filling
  16. 16. 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
  17. 17. Protrusion
  18. 18. Protrusion & Width• Before• After
  19. 19. Camouflage with Beard
  20. 20. Protrusion
  21. 21. Before & After
  22. 22. Before & After
  23. 23. Before & After
  24. 24. Before & After
  25. 25. Before & After
  26. 26. Before & After
  27. 27. Before & After
  28. 28. Before & After
  29. 29. Before & After
  30. 30. Balance
  31. 31. Strength
  32. 32. Balance
  33. 33. Why Such A Long Face??
  34. 34. Great Chin!!!
  35. 35. Thank You Dr Paul Spano Medical Director SKINOVATE Melbournewww.skinovate.com.au

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