Alternatives to Botox/HA fillers for chin dimpling and labiomental hollows? (Photos)

Question

Hi - i am looking for something at least semi permanent for this uncommon issue. I know HA fillers can last for years in certain places, but not where there is a lot of muscle activity. Can something like sculptra work to smooth out my chin and also hide the hollows on the sides that disconnect my lower cheeks from the chin and make my face look saggy when im young? I already had fat transfer to other parts of my face a month ago and i dont want to go through the trauma again. Im a powerlifter and a month later I still cant deadlift as heavy after sucking so much fat from my core. Thank you ! (I already have a 8mm genio)

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Given your situation and goals, a biostimulatory filler like Sculptra could be a good option for addressing the chin and lower face hollows in a more semi-permanent way. Unlike hyaluronic acid (HA) fillers, which mainly add volume and can be metabolized relatively quickly in areas with movement, Sculptra works by stimulating your body’s collagen production over time, leading to gradual and longer-lasting improvement in skin thickness, firmness, and contour. It's particularly effective for diffuse volume loss and can help blend the transition between the chin and lower cheeks, giving a more lifted, youthful appearance without looking overfilled. While Sculptra doesn’t offer immediate results, it may be preferable for someone like you who wants something lower maintenance and is hesitant to undergo another fat transfer, especially after the physical toll it took on your performance and recovery as a powerlifter. I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

If you're looking for a simple, relatively inexpensive procedure for skin indentations that has a several decades" long track record for safety and effectiveness, as well as producing durable, long-term results, consider subcision, which I have been performing for the past thirty years for elevating and smoothing the dimples.  You would be wise to consult with an experienced, board certified cosmetic dermatologist and best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for your thoughtful and detailed question. Based on your concerns and the photo, you're dealing with a combination of mental crease/labiomental hollowing, chin dimpling, and contour separation between the lower cheeks and chin, likely worsened by strong mentalis muscle activity and fat loss in adjacent areas.

Non-Filler & Semi-Permanent Alternatives to Consider:
1. Sculptra (Poly-L-Lactic Acid)
Yes, Sculptra is an excellent option here. Unlike HA fillers, it works by stimulating your own collagen over time, making it semi-permanent and less prone to migration from dynamic movement. It’s particularly effective for volume-deficient areas and blending transitions—like those hollow zones along the sides of your chin. Just keep in mind that it takes multiple sessions spaced out over weeks to months to see the full effect.

2. Hyperdilute Radiesse
This can be used to firm the skin, reduce dimpling, and improve textural changes. It’s injected superficially and stimulates collagen, but unlike Sculptra, it gives some immediate volume as well. Particularly good when fine tissue support is needed without bulk.

3. Botulinum Toxin (Optional)
While you asked about alternatives, a conservative dose of Botox into the mentalis muscle could help soften the dimpling if it's due to overactivity. This isn’t permanent, but in combo with collagen stimulators, it allows the skin to "settle" during the regeneration phase.

4. Microneedling with Radiofrequency (RF-MN)
If textural irregularity or scarring-like skin tension adds to the visual disconnect, RF microneedling (e.g., Morpheus8, Secret RF) can stimulate dermal remodeling and help improve contour blending over time.

5. Thread Lifts (Optional Consideration)
If your issue includes early skin laxity that creates shadowing or volume division, barbed PDO threads could help reposition tissue—though it’s not the most permanent, and results vary with facial activity.

Additional Note on Your Fat Transfer:
Given you’ve recently had facial fat grafting and are still recovering from the core harvest, avoiding further invasive procedures makes sense. Sculptra or Radiesse, done conservatively, could integrate well with your current results and support long-term maintenance.

Let me know if you’d like guidance on ideal dilution or injection planes for your specific goals—especially if consulting with an injector familiar with treating athletic, lower-fat facial types.

Darryl J. Blinski, MD · Answer

Based on the one posted photo only and not a series of photos showing muscle action of the chin therefore recommend virtual consultation. Options are as follows a combination of SCULPRA/R a DIESSE injections, possibly one vile and one syringe And impossible. Repeat treatments. Fee for that is $1500. Or allograft fat two companies :Renuvion or Alloclae injections, possibly 2-3 syringes of the of of the first option or one syringe of the second option. Fee range approximately 1800 to 2500 per treatment best of virtual consult with for more detail. Details regards the

Alternatives to Botox/HA fillers for chin dimpling and labiomental hollows? (Photos)

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