Can I achieve a pointed chin/heart shaped face with a chin implant or am I better off with filler? (Photos)

Question

I am almost 11 months post op rhinoplasty which has left the tip of my nose swollen, given it a slightly crooked appearance, and somewhat turned me off to the concept of invasive surgery since my appearance is now objectively worse. That being said, I still desperately want to improve my profile. My chin is rather shallow and I'm wondering what is truly the most effective way to achieve the results I want (photos of ideal also included). Please advise.

Michael Kulick, MD, DDS · Answer

Hello Sophie,Thank you for your questions and pictures. You are correct, your chin is weak relative to your nasal projection. Using a filler to improve your chin shape may make you happy temporarily. However, a surgical solution may be a better option. I recommend fillers for patients that are inconsistent in terms of the amount of projection they are looking for. It seems that you have a good vision of what your profile could look like. To help with communication, I often use computer morphing along with pictures patients bring in prior to surgery. It provides a patient a way to see how their chin profile may look after surgery and what type of implant is selected. Take a look at the link provided. You can also go to the rhinoplasty section to see patients that had nasal surgery and a chin implant.Hope this helps!Sincerely,Dr. K

David C. Mabrie, MD · Answer

Hi SophieMoreau,
  
Thank you for your question and sharing your photographs! Great job on providing photo examples of the facial shapes you admire, those are always helpful. I understand your frustration with surgical recovery and unpredictable outcomes, it can take up to a year to truly evaluate the results of your rhinoplasty.
  
Overall, you have a nice facial shape with lovely cheekbones. I can see some areas where placing dermal filler can improve your facial harmony.
  
Non-Surgical Chin Augmentation is definitely an option for you. Adding projection to the chin and feathering out the jawline can help achieve a more sculpted look like your photo examples.  
  Non-Surgical Chin Augmentation is one of my favorite procedures because it can benefit both men and women. The results are immediate, and, because it’s non-invasive, we can work together to achieve your ideal facial shape during your appointment. Dermal fillers allow me to sculpt with precision that is greater than working with a surgical implant. I like using Juvederm Voluma in the chin because of its thick, spongy consistency. It can also be revered if needed, giving you more control over your results. Good luck and stay beautiful!

William Portuese, MD · Answer

From the side profile photographs, it appears that there is a weak and a recessive chin profile for  which A chin implant can improve.  Chin implants offer a 3-dimensional augmentation of the mandible which includes mostly forward projection, some added width, and a small amount of vertical height.  Chin implants are manufactured in a large variety of sizes and shapes, and can be custom carved when necessary to meet patient's unique anatomy.  In our practice, we use Implantech solid silicone anatomical chin implants with an excellent success rate for over 25 years.  For more information, diagrams of the implants and many before and after examples, please see the link and the video below

Vincent D. Lepore, MD (retired) · Answer

From your photos, it may be possible to achieve the results you are looking for with either an implant or injectable fillers.  Of the two, the implant will have the advantage of giving you a more permanent result.  However, if you are not certain about the shape or size of the implant, injectable filler can be somewhat more controllable in that the injections can be performed at more than one sitting.  The downside - the fillers do resorb over time.  Of the fillers, Voluma, can last up to two years.  Best wishes, Dr. Lepore.

Michael Elam, MD (retired) · Answer

Dear SophieMoreau, It is a shame that your surgeon did not perform a chin augmentation at the time of your rhinoplasty to provide a better balance to your profile and overall facial aesthetic. I would suggest that you seek consultation and have imaging performed to show you how chin augmentation would effect your profile. You can see in the video above the imaging process and how it works and how close in proximity the end results are to the projected results. Having this performed will give you a good idea to see if this change in fact would meet your expectations. Personally, I believe a chin augmentation would nicely balance your face. See the link below as well for further examples. Best regards, Michael V. Elam, M.D.

Richard W. Fleming, MD (retired) · Answer

Injecting fillers in your chin will provide more volume but an implant will permanently give you more chin projection and definition. I suggest you talk to your surgeon or a revision rhinoplasty specialist about your nose.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I performed many facial shaping procedures using dermal fillers and facial implants (Cheek implants, chin implants, lip implants) over the past 30 years. You question really has two parts.  The first part is whether shaping your chin with a dermal filler or a chin implant will give you a heart shaped face?  The answer is an emphatic no!
 For over 3 decades, I have formulated beauty principles of the face and body, that among other things, established that women look the most feminine, youthful and attractive with heart shaped faces.  All heart shaped faces have cheeks that are full and round in the front.  The chin, whether weak or properly projected (discussed below) doesn't have the aesthetic ability to create full, round cheeks in the front of the face and as such no ability to create a heart shaped face.  If we look at the attached pictures, your face is an elongated, rectangular shape.  This occurs because your cheeks are very flat in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face and create a heart shaped face.
 Now let's discuss your chin.  Looking at the photos, especially the profile it appears that your chin is quite weak.  This is evidenced by the lack of forward projection of the chin using an imaginary line drawn down from the "lower" lip as you seem to be demonstrating in one of the photos.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face appears short, lip fullness is de-emphasized and early formation of a "double chin" occurs.  Chin augmentation using either a dermal filler or a silastic chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective...can be done in 30 minutes or less often using a local anesthetic alone.
 So to summarize, your chin is indeed weak and it can be augmented using either a dermal filler (temporary results) or by placement of a silastic chin implant for a permanent enhancement.  There are specific sizes and shapes that I prefer using and belief that the implant is best placed through a small, curved incision under the chin (not through the mouth that has unwanted side effects).  This is far less invasive than a sliding genioplasty which requires bone cuts, metal screws or plates.  In my humble opinion fat transfer, despite its recent popularity offer far less of a reliable volume than an off the shelf dermal filler or a chin implant and for that reason, I do not use fat to shape the chin, cheeks or jaw line.
 Next is that you are correct as a woman in seeking a heart shaped face.  This can only be accomplished with cheeks that are properly shaped: and these are cheeks that are shapely, full and round in the front.  Your face currently is rectangularly shaped but cheek augmentation using either a dermal filler (again provides temporary results) or using cheek implants for a permanent enhancement can create cheeks that are full and round in the front thereby softening and feminizing the entire face by making it heart shaped. When using silastic cheek implants it's paramount that the proper size, shape thickness and placement of the implants is achieved in order to create the proper aesthetic cheek shape.
Hope this helps.

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