Date post: | 03-Jun-2015 |
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Health & Medicine |
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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