J Cosmet Med.  2017 Dec;1(2):120-129. 10.25056/JCM.2017.1.2.120.

Subperiosteal chin augmentation with hyaluronic acid filler in patients with a small chin

• Kang K
• Chai C

• KMID: 2561043
• DOI: http://doi.org/10.25056/JCM.2017.1.2.120

Abstract

Background
For correction of small chin, surgical genioplasty, allograft implantation, and injectable filler have been widely used. Among these, the injectable fillers is a simple, non-invasive procedure that has minimal downtime and low risk of complications. It has been commonly injected at intradermal, subdermal, submuscular and supraperiosteal layer. However, common complications such as nodules, bumps, lumps, migration, asymmetry, overcorrection, and chin ptosis frequently happened.
Objective
The main objective of this study was injecting filler into sub-periosteal layer in a small chin and evaluated its effect and incidence of complications.
Methods
A total of 14 subjects aged between 33 and 64 years had been performed Elravie ® hyaluronic acid filler injection subperiosteally and Medytoxin ® as a botulinum toxin treatment intramuscularly. Morphological change were observed through the photos. Changes of proportion of lower 1/3 face, Modified Legan’s angle, and open gap distance of lips were measured. Follow-up patient satisfaction surveys were conducted from 2 to 3 weeks.
Results
Proportion of lower face was significantly changed that the ratio of upper and middle 1/3 were decreased (5.26%, 3.85%) and the ratio of lower 1/3 was increased (8.33%). Modified Legan’s angle was significantly decreased (37.4±16.5%). Open gap distance between lips was decreased (66.2±17.9%) and dry mouth was significantly decreased. Lower facial contour was changed from round shape to elliptical shape and mouth looked smaller and less protruded. Upper lip was everted, but lower lip was inverted. Perioral wrinkles, labio-mandibular folds, and mental dimples were significantly decreased. There was no significant incidence of common complications including chin ptosis.
Conclusion
Subperiosteal filler injection is easy, safe and effective in improvement of small chin and interestingly, showed additional beneficial effects such as improvement of dry mouth, lips contour, and perioral wrinkles. Level of Evidence: IV

Keyword

subperiosteal chin augmentation; injectable filler; chin ptosis; dry mouth