The Art of Facial Harmony: Why the Chin Matters
When we first began exploring facial aesthetics, the foundational principles we learned were the rule of thirds and the rule of fifths—the ideal proportions that define a balanced face. A retruded chin or any disharmony between the maxilla and the mandible immediately disrupts this balance. You can see it in your patients. Understanding how profoundly the chin influences overall facial proportions is essential. An old wisdom taught us: always adjust the chin in proportion with the lips and the nose. For me, the first stone analysis is the most reliable guide because the subnasale is a fixed reference point. We commonly use the E line and the Rets line in our clinic, but I always return to the first stone analysis. It is critical to harmonize every subunit of the face with each other. We are now seeing strange trends—the "witch chin" for example—and I call these procedures "Halloween procedures." Our aim is to beautify, not to disfigure.
When Trends Go Wrong: A Word of Caution
Social media has given rise to peculiar trends, like the "luran strips lips" or the "butterfly lips." Some practitioners even dissolve old filler only to reinject new filler in the same session, then tape the lips with plastic tape and call it the "Michelangelo technique." I am sure Michelangelo has nothing to do with this—he is resting in his grave. These techniques go against our core role as aesthetic providers. Recently, I have been shifting away from volume augmentation for the lips. For patients with acceptable lip proportions, I explore the use of non-crosslinked hyaluronic acid as a skin booster. This is a purely therapeutic approach. It does not add volume. It removes wrinkles and fissures, improving texture. I published research on this: the fissures and cracks are eliminated, and the lip gains a better texture—without any volumization. You can use Revan as pure, or any non-crosslinked hyaluronic acid skin booster. I am also investigating polynucleotides for the lips, again as a skin booster for hydration. In one patient, I injected a polynucleotide (Rona, if we are allowed to mention brands) using a four-point cannula technique: one entry point here, one here, one at the lower lip tubercle, and one on the other side. Four points of entry, advancing the cannula to inject the polynucleotide. I place a micro-alot in each lip tubercle, aiming for hydration. But today, we are not here to discuss lips. We are here to discuss chin filler.
The Chin Filler Technique: Safety and Precision with the Cannula
Most practitioners use needles for the chin, but you should rethink this. There is always a possibility of vascular occlusion in the chin, or worse, a lingual occlusion. Knowledge of anatomy, especially with ultrasound experience, is crucial to avoid complications. And remember, anatomical variations are common. A vascular occlusion can happen to anyone. It is rare, but you must understand the risk: the connection between the sublingual and mental arteries, and sometimes a median lingual foramen in the midline—a midline lingual canal. Injecting at the midline of the chin can easily lead to vascular occlusion if you are not careful. My technique uses a cannula. I call it the "Three Tips" chin filler technique. It will be published in PRS Global Open next month. The approach is designed to minimize risk and maximize precision, respecting the facial subunits and the individual anatomy. The cannula allows me to navigate the tissue layers safely, avoiding the dangerous midline structures. This is not just about filling the chin; it is about restoring harmony with the lips and nose, using the first stone analysis as my guide. The goal is to beautify, not to follow fleeting trends. The chin is a powerful feature—handle it with wisdom and respect for the underlying anatomy.