David C. Mabrie, MD

Hi Petewill,

Thank you for the question and the photo. It appears that there are two things going on.  

First, it appears that you have a hyperactive Mentalis muscle.  This causes the chin to have a dimpled or wavy appearance.  Placing a minimal amount of Botox to this area would help to relax the muscle and lessen the "wrinkly" look.  

Secondly, it seems that there may be some asymmetry to the left chin and jawline.  This could be addressed and evened out with the use of dermal fillers such as Juvederm Voluma or Radiesse. 

Here is a video that goes into further detail about treatment of the chin and jawline.

We hope this is helpful. Good luck and stay beautiful!

~ Mabrie Facial Institute

Hi samornas,

Dermal fillers are a great way to treat jowling.  The best way to help diminish the appearance of this area is through a multifaceted approach - treatment to the chin, jawline and pre-jowls.  

Placing a filler, such as Juvederm Voluma, to the chin and Juvederm Ultra Plus along the jawline will help to provide symmetry and correct indentations along the jawline that exaggerate the appearance of the jowls.  

Then placing a filler, like Juvederm Ultra, to the pre-jowl/oral commissure areas will help to fill in the “step-off” that creates the jowls themselves.  By treating these areas as one unit, you help to ensure a seamless and smooth transition from different areas of the face.

It is important to know that each filler has different molecular structures and its own unique characteristics (e.g. consistency) which makes them more or less appropriate for one area but not the other. 

Seek out consultation with a well-qualified injector so that they can tailor a treatment plan specific to your anatomy and aesthetics.

Here is a video detailing how to treat the jowls. 

We hope this helps.  Good luck and stay beautiful!

~ Mabrie Facial Institute

Hi soulsurfer1507,


both fillers that you have mentioned are great options to treat the chin, jawline and cheekbones.  It essentially comes down to what you are aesthetically hoping to accomplish and your comfort with the properties of the particular fillers.  

Juvederm Voluma is a hyaluronic acid that helps to add volume to cheeks and cheekbones.  It is a reversible filler, meaning that it can be dissolved at any time should you need or want, and it lasts for about 2 years.  

Radiesse is made from a calcium based product and, while it does add some volume, it really helps to add contour and definition to chin, cheekbones and jawline.  It is a non-reversible filler and lasts for about 15 months.

It is also important to note that these fillers can be used in conjunction with one another - sometimes providing the perfect combination of volume and definition.

It is difficult to predict the total amount of syringes that would be needed without an in-person consultation, but a good place to start is with 4 syringes. Seek out an experienced injector that can tailor a treatment plan specific to your anatomy and aesthetic.  

Here is a video that touches on filler options, jawline treatment and cheekbone treatment and a link to our blog on defining the jaw and jawline with dermal fillers. 

We hope this helps.  Good luck and stay beautiful!

~ Mabrie Facial Institute

Hi RomiNash,

we are sorry to hear that you have been dealing with this situation for such a long time.  Treating the under eyes (tear troughs) is an anatomically challenging area.  From your description and photos, it appears the issue is stemming from an inappropriate placement of the filler - it was not placed at the correct depth.  

To properly treat the under eye area it is important to treat adjacent areas (particularly the larger midface and cheek) to support the orbital rim and tear trough.  Ignoring these “support” areas can create heaviness under the eyes or pooling of filler — the exact opposite of our goal.

To correct your results we recommend dissolving the old filler that is trapped beneath the skin with Hylenex (hyaluronidase). You may need a few rounds of dissolving before refilling the under eyes. 

Make sure to do your research and find an experienced injector who specializes in treating the under eyes. 

Here is a video that further explains what hyaluronidase is and how it works. 

We hope this helps.  Good luck and stay beautiful!

~ Mabrie Facial Institute

Hi alexikscholler,

fillers are a great way to shape, contour, and highlight your features, so you don't have to wait for the first signs of aging for treatment.  Many men/women in their 20-30s are choosing fillers to enhance and define their cheekbones, nose, chin, jawline, and lips.  Additionally, some patients may have dark circles or sunken eyes due to genetics that can cause a sleepy or tired appearance.  Using fillers, we can add volume to facial concavities to diminish these concerns.  

When placed appropriately, these fillers will look completely natural and enhance the attractiveness of the face.  It will not, however, permanently change your natural facial features. That is to say, if you were to discontinue the usage of fillers or dissolve them, the face would revert back to its original look prior to treatment.  The amount of product used will not stretch out the skin and/or alter the tissues it is placed to.  

While rare, it is possible for fillers to move if not placed appropriately. That is why it is of paramount importance to choose a well qualified and experienced injector.  

For more information pertaining to cheek augmentation, please check out this video and the link to our website.

We hope this is helpful. Good luck and stay beautiful!

~ Mabrie Facial Institute