Chin and Jawline Filler

What is chin and jawline filler?

Chin and jawline filler is the injection of a dermal filler to treat loss of contour and volume in the lower face. The target points are the most prominent point of the chin, the labiomental groove (the horizontal hollow between the lower lip and the chin), the melomental folds (the area commonly known as marionette lines), the area in front of the jowls (prejowl area), and the body and angle of the jawbone.

There are anatomical reasons why this area changes with age. With ageing, the jawbone recedes at the front and along its lower edge, the angle of the jaw widens, and the chin projects further forward but becomes shorter. The fat around the lower jaw diminishes, a connective tissue partition in the area opens up, and jowls (sagging along the jawline) form. Filler targets the volume and contour part of this change; it does not target skin quality, the muscles or the bone itself.

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What does ‘jawline’ mean, and which area does it describe?

‘Jawline’ is an English word that has entered everyday Turkish; the Turkish equivalent is ‘alt çene hattı’ (the line of the lower jaw). It describes the line that starts at the chin and runs along the outer edge of the jawbone to the angle of the jaw in front of the ear.

In everyday language, ‘chin filler’ and ‘jawline filler’ are often used interchangeably, but medically this area is not treated as a single target. At the chin, the issue is projection, meaning how far forward the chin sits. Along the body and angle of the jawbone, the issue is contour, meaning how clearly the edge of the line is defined. You may have only one of these, or both; you may also have neither. Which one applies is determined at a consultation.

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When is it considered?

Filler treatment in this area is considered in the following situations:

• A chin that sits too far back (in mild to moderate cases).
• A jawline whose edge has become blurred, so the line is no longer clearly visible.
• A hollow in front of the jowls (prejowl area) and sagging along the jawline.
• A deeper labiomental groove and more visible melomental folds.
• Age-related loss of volume and contour around the lower jaw.

This list shows when the treatment may be considered; whether it is suitable for you is assessed at a consultation.

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Chin, jawline and double chin are separate questions

What looks like a single concern in the mirror is often three separate issues: the position of the chin, the contour of the jawline, and fullness under the chin (the submental area, commonly called a double chin). These three have neither the same cause nor the same solution.

Filler addresses loss of volume and contour. Studies show that in people with marked fat under the chin and advanced skin laxity, the effect of filler is limited, and that these conditions are treated with surgical methods. So if the fullness under your chin comes from fat or from loose skin, filler along the jawline will not resolve this concern. Which factor is dominant is established at a consultation; a decision made without this distinction leads to a mismatch between expectations and results.

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The jawline in male patients

The chin and jawline stand out in the questions men ask about their faces. Scientific publications state that the lower third of the face is decisive in whether a face is perceived as masculine. Men considering aesthetic injections are reported to have two main concerns: that the result will look feminine or unnatural, and side effects. That is why the initial consultation is itself part of the process.

This concern also has an anatomical basis. In a three-dimensional computed tomography study of 275 people in Korea (151 men, 124 women), the length of the jawbone, the depth of the antegonial notch (an indentation on the lower edge of the jawbone, in front of the angle of the jaw) and the width between the two angles of the jaw were significantly greater in men. The angle of the jaw was narrower in men, meaning more angular. Chin shape also differed: predominantly round or square in men, and predominantly pointed in women.

In practice, this means the target shape is not the same for male and female patients. Scientific sources recommend keeping the chin square and prominent in male patients, and the jawline wider. However, all these measurements are group averages from a single population in a single study; they reflect neither the population in Türkiye nor any one person’s face. Your own bone structure is determined at a consultation, not by averages.

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Limits of this treatment

Studies clearly set out where hyaluronic acid (HA) fillers are suitable: mild to moderate loss of facial contour and volume, and mild to moderate laxity. More advanced cases may need surgery.

In concrete terms, this means:

• If the chin is markedly receding, filler has a limited effect; in this case, surgical options (genioplasty, i.e. chin surgery) are considered. It would not be right to give a millimetre threshold for this distinction: the millimetre measurements in publications describe what was done in individual groups of patients; they are not a criterion for deciding who is suitable for which method. This is why measuring your own chin with a ruler tells you nothing.
• If there is advanced skin laxity, filler does not tighten the skin.
• If there is a marked build-up of fat under the chin, filler does not reduce this fullness.
• If the chin is asymmetric or lacks vertical height, surgical options are considered.
• Hyaluronic acid fillers are not permanent; they are gradually broken down by the body over time.

This information is not given to steer you towards a particular method, but so that you can compare the options. Which route makes sense for you (filler, a surgical option or neither) is decided by the assessment at your consultation and by your own decision.

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Possible side effects and complications

In studies of hyaluronic acid fillers in the face, the most commonly reported effects are reactions at the injection site. In order of frequency, these are swelling, bruising, pain, firmness or lumps you can feel, and redness. These effects have mostly been reported as mild, resolving on their own and reversible.

Giving a single rate for how often these effects occur would be misleading. Study results vary widely; for example, the true value of the rate calculated for swelling could lie anywhere between one fifth and two thirds. A single percentage gives an impression of precision that the data do not support, and suggests that you could calculate your own risk. In addition, these data come from treatments in all areas of the face; they are not specific to the chin and jawline, and they are not this clinic’s data.

Delayed-onset nodules (small firm lumps you can feel under the skin), foreign body granulomas (a tissue reaction the body develops against the filler) and infection have also been reported.

The most serious reported complication is filler entering a blood vessel. In this situation, ischaemia (when tissue is not getting enough blood), skin necrosis (tissue death) and vision loss have been reported. One case from the chin area, in which injection into a blood vessel brought the skin close to necrosis, has been published in detail. Unlike injection-site reactions, these serious complications have been documented in individual case reports; however, this does not mean the risk can be ignored. These risks must be explained to you before the treatment.

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Can filler be reversed?

For hyaluronic acid fillers, yes: these fillers can be dissolved with an enzyme called hyaluronidase and are classed as reversible fillers. Fillers containing calcium hydroxylapatite (CaHA), poly-L-lactic acid (PLLA) or polymethyl methacrylate (PMMA), on the other hand, are non-reversible fillers; these types of filler also stay in the tissue for different lengths of time.

That is why the type of filler to be used is an important question. Before treatment, it is worth asking which filler will be used, whether it is permanent and whether it can be reversed.

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Blood vessels and nerves in this area

The jawline differs in one respect from some other areas of the face treated with filler: according to scientific sources, there is no major blood vessel or nerve along this line just under the skin or in the subcutaneous fat (the fat layer under the skin). However, this does not mean the area is risk-free. The nearby structures need to be well understood: the facial artery and facial vein, the marginal mandibular nerve, the parotid gland (a salivary gland) and its duct, and the masseter (chewing muscle). The marginal mandibular nerve is the nerve that controls the facial expression muscles that move the lower lip.

The chin and the area under the chin are a separate matter. This area contains the submental artery (the artery under the chin), the inferior labial artery (the artery of the lower lip) and the mental artery. The submental artery has been reported to be the largest branch of the facial artery in the neck, with an average diameter of 1.69 mm, and to supply an area of about 45 cm². In one case published in detail, hyaluronic acid filler injected into the chin area entered a blood vessel and brought the skin close to necrosis. Immediately after the injection, blanching (the skin turning pale or white) and a net-like discolouration (livedo reticularis) were seen.

This information is not given to put you off the treatment, but to explain why this area needs care. The layer the filler is injected into, the method used and the amount depend on the doctor’s own assessment and technique.

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