Ruined chin after chin filler - What can I do to fix this? (photo)

Question

I had chin filler done, 0,3 ml Juviderm, injected under the muscle. Done with only one injection point, which felt like around the middle of my chin. The result was a sudden appearance of weird lines/rippling on the sides of my chin (especially the left side), as well as a kind of dimple or «hole» on the underside of my chin, when I am smiling with my teeth (even more visible if I strain my chin to grin, like in an attempt to show all my teeth). I got the filler removed after two weeks - twice - using the same injection point. But the lines and rippling and the weird dimple under my chin are still there. Can the muscle have been damaged or changed in some way by the filler? Or, can some filler have migrated/slid to the sides of the chin and underneath the chin, and caused the rippling and the dimple? And is it even normal to put the filler UNDER the muscle? What can I do to fix this? Please help.

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. It sounds like you're dealing with some unexpected side effects after your chin filler procedure. Injecting filler under the muscle is actually a common technique, especially when you're aiming for structural support and a more defined chin. However, the technique requires precision. The muscle in the chin area (often the mentalis muscle) can be quite dynamic, especially when you move your mouth or smile. If the filler is placed too deeply or unevenly under the muscle, it may create irregularities, as you’ve noticed, such as rippling or dimples when you smile. It’s also possible that the filler migrated or spread after injection. Filler doesn’t always stay exactly where it’s placed, particularly in dynamic areas like the chin, and this migration can lead to uneven distribution, resulting in rippling or an indentation. While it's unlikely that the muscle was directly damaged by the filler, it’s possible that the filler interfered with the natural function or movement of the mentalis muscle, especially if there was an imbalance in the placement. Since you’ve already had the filler removed, here are some potential next steps to help improve the situation:
-Massage or Manual Manipulation: Sometimes gentle massaging of the area can help encourage the filler to redistribute or settle more naturally.
-Hylenex Injections: If there’s still some residual filler in the area causing the irregularities, Hyaluronidase (Hylenex), an enzyme that breaks down hyaluronic acid fillers, can be injected. If the filler wasn’t fully dissolved in the first round of removal, additional enzyme injections may be helpful.
-Time for Natural Absorption: If you're still early in the process, your body may naturally absorb and redistribute the filler over time, although the rippling or dimple might persist if the filler was overfilled or poorly placed. This could take a few months.

I hope this helps and best of luck!

Scott Trimas, MD · Answer

Chin filler is often placed directly on the bone to minimize risk of injected into a blood vessel. This is a common area for vascular occlusions, so product placement sounds correct. One single injection point is odd- from the photos it looks like you may have needed a smoother product in your chin shadows and something firm for the projection of the chin- but you only received projection which may have accentuated the volume loss creating the lines on the sides of chin.
Hyaluronidase (used to dissolve) can destroy some of your natural hyaluronic acid along with the target filler. This is also a highly mobile area, the mentalis muscle is very strong, and can often push the filler and cause migration depending on product choice. Chin filler is best paired with botox in the mentalis to prevent this.
From here you have a few options- Botox in the mentalis and DAO muscles can help smooth the area but it is temporary and will not address the indention left behind. I would recommend allowing a few months for the area to heal/recover and then consulting with a board certified facial plastic surgeon that works with an aesthetic injector to consider filler or more permanent products in the area if the problem persists.

Jonghyun Hong, MD · Answer

Hello, this is Dr. Hong from Fresh Clinic in Seoul, South Korea.
Thank you for sharing your photo, and I’m truly sorry to hear about your experience with the chin filler. Managing complications after dermal filler treatments can be quite challenging.
Injecting filler, fat, or other substances beneath the muscles is not standard practice and is generally considered inappropriate. This may explain why hyaluronidase hasn’t been effective&mdash;if the filler was injected too deeply, especially under the muscle, the dissolving injection must be placed at the same depth to work properly.
I hope you're not experiencing any pain, signs of inflammation, or other concerning reactions?
Unfortunately, filler cannot be clearly identified on ultrasound or CT scans, which makes it difficult&mdash;but not impossible&mdash;to determine its exact location. If dissolving injections fail to work, mechanical removal using a cannula technique (similar to liposuction) could be considered as an alternative.
However, because the filler may be located between or under muscles, you’ll need a highly skilled specialist&mdash;preferably someone experienced in liposuction or foreign body removal. Simply finding a board-certified doctor may not be enough, as those without hands-on experience in these specific cases may not be able to help effectively.
I sincerely hope your symptoms improve soon, and that you can put this experience behind you like a bad dream.
Warm regards,Dr. Hong

Eric M. Joseph, MD · Answer

If you have had the filler dissolved twice, I'm not sure that a third time would be beneficial. It's consider meeting with a reputable facial plastic surgeon, or cosmetic dermatologist for advice moving forward. Thank you for this question. Sincerely, Dr Joseph

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about your experience with chin filler. Addressing complications after dermal filler treatments can be challenging, but there are steps you can take to improve the situation. Here are some suggestions and considerations:

Consult with a Specialist: It's crucial to consult with a board-certified dermatologist or plastic surgeon who specializes in facial aesthetics. They can assess the situation in person and provide expert advice tailored to your specific case.

Filler Migration: It is possible that some filler may have migrated, causing the rippling and dimpling. A skilled specialist can help determine if this is the case and suggest appropriate treatment options.

Muscle Impact: While fillers are generally injected into specific layers of the skin, injecting under the muscle is less common and might affect the muscle's appearance or function. A specialist can evaluate if there is any muscle alteration and suggest corrective measures.

Time and Healing: Sometimes, the skin and tissues need time to heal after filler removal. The appearance of lines and dimples may improve over time. Your specialist can advise on the expected timeline for recovery.

Corrective Treatments: Depending on the evaluation, treatments such as additional hyaluronidase (to dissolve any remaining filler), laser therapy, or microneedling might be recommended to improve skin texture and appearance.

Physical Therapy or Massage: In some cases, gentle massage or physical therapy may help improve the appearance of the affected area by promoting circulation and tissue recovery.

Avoid Further Procedures: Until you have a clear understanding of the issue and a treatment plan, it might be best to avoid any additional cosmetic procedures on the chin.

Documentation and Follow-up: Keep detailed records of your treatments, including dates and products used, and maintain regular follow-up appointments with your specialist to monitor progress.

Addressing these concerns can take time, but with the guidance of a qualified professional, you can work towards improving the appearance of your chin.

Ruined chin after chin filler - What can I do to fix this? (photo)

Answers (5)

Answer: It is difficult to answer your question without before and after photos.

Answer: It is difficult to answer your question without before and after photos.

Answer: Addressing Complications from Chin Filler: Steps to Recovery and Improvement

Answer: Addressing Complications from Chin Filler: Steps to Recovery and Improvement

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Everything you need to know about Chin Filler

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Ruined chin after chin filler - What can I do to fix this? (photo)

Answers (5)

Answer: It is difficult to answer your question without before and after photos.

Answer: It is difficult to answer your question without before and after photos.

Answer: Addressing Complications from Chin Filler: Steps to Recovery and Improvement

Answer: Addressing Complications from Chin Filler: Steps to Recovery and Improvement

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Recommended reading

Everything you need to know about Chin Filler

Our mission is to create a world where every investment in modern beauty is Worth It.