๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Indications
Indications
The chin area contributes to both male and female attractiveness131 and is one of the most prominent elements of the lower third of the face.132 When looking at this area, the injector should perform a comprehensive facial assessment both at rest and with
animation, with particular focus on mentalis muscle activity, the chinโs soft tissue and bony support, and the chinโs three-dimensional axes (anteroposterior, superoinferior, and transverse axes). Other facial areas to be evaluated in addition to the chin include the perioral region, lips, nose, and teeth.132 Those with microgenia and micrognathia/retrognathia may benefit from anteroposterior and superoinferior dimension corrections with volumizing fillers to the mental area. Excessive chin protrusion (mandibular prognathism) can indirectly benefit from augmenting the upper lip and anterior nasal spine to balance the nose/upper lip and bring them forward. Anteroposterior chin augmentation indirectly helps minimize the appearance of maxillary prognathism and bulbar nasal appearances. Superoinferior axis prolongation can aid in retaining facial asymmetry in isolated microgenia and achieving more triangular feminine appearances with central chin augmentation superoinferiorly. Moreover, BTX-A to the mentalis can aid in elongating the chin area, attenuating the labiomental crease, and softening the peau dโorange appearance often seen with mentalis contraction. Transverse axis enhancement gives a more squared masculine appearance and should be approached with caution in females. Patients considering permanent chin implants might find that temporary filler injections can provide a useful preview of results that might be obtained with surgical implants.
Fillers Juvederm Voluma, Restylane Volyme, Restylane Defyne, Restylane Lyft, Belotero Volume, and CaHA can be used because of their volumizing and lifting properties. Bolus and towering techniques may be used to preferentially expand any or all of the chinโs three dimensions while maintaining the labiomental sulcus. Needles of 27- to 30-gauge size may be used for precise filler placements. Supraperiosteal towering or subcutaneous boluses to two points approximately 1 cm lateral to the midline and midway between the labiomental crease and mental border can provide anteroposterior axis augmentation. Subcutaneous or supraperiosteal towering injections in the midline approximately 1 cm inferior to the most anterior mental border can enhance the superoinferior chin axis giving the face a more elongated and triangular feminine appearance. Augmentation of the transverse axis can be achieved similar to the superoinferior injection technique; however, the injection points are placed at the lateral borders of the chin. A cannula technique to selectively augment the chin in the desired plane may be used as well. The entry point or points are typically located lateral to the chin in the prejowl region. Because of the fibrous nature of tissue in this region and strong mentalis activity, this can be an uncomfortable area to treat. It is also more common to experience posttreatment discomfort in this area because of edema.