The Art of the Subtle Chin: A Lesson in Tissue Respect
Every face tells a story, and the chin is often the final punctuation mark. In this treatment, we are working to create a seamless, tapered appearance from the jawline, adding just a whisper of projection at the chin. The key is not force, but finesse. The skin type in this area—what we call type two skin—is tightly adhered to the muscle and fat beneath. A stiff gel would be a blunt instrument here. Instead, we choose a softer product, Revanesse Ultra, because its delicate nature allows for a more comfortable experience and a result that whispers rather than shouts.
Accessing the chin requires respect for the underlying anatomy. The mentalis muscle originates from the mandible and inserts into the skin. To reach the correct plane, we approach from the side, moving the cannula towards the midline. You will feel a slight resistance at the border of the mentalis muscle—that is your guide. A gentle push of gel, which contains lidocaine for comfort, allows us to fan the product into the chin, creating not just anterior projection but also a downward direction, subtly reshaping the structure. The cannula is the preferred tool here because it allows us to blend the product smoothly across this midline structure. For more significant retrognathia, a deeper, firmer product like Shape or Contour can be placed first, with the softer gel layered on top—a powerful combination of techniques.
We then cross the labiomental crease, a region that may need a little numbing cream due to its tightness. With a gentle fanning motion, we deposit the product. After treating half the face, the result is already visible: the chin now points downward, completing the beautiful jawline projection. A total of 0.6 cc of Revanesse Ultra was used for this subtle yet transformative change.
The Lips: A Study in Proportion and Precision
Lip filler is the most popular treatment globally, and for good reason—the lips are the central feature of the face. In this case, the patient already has a beautifully defined lip border and classic proportions. The volume of the lips aligns with the width of the nose and the distance between the corners of the eyes. The lower lip is slightly larger than the upper, occupying about two-thirds of the height. The lips themselves sit in the upper third of the lower face, which is ideal for a feminine shape. The goal here is not to alter the shape, but to add a touch of hydration and projection.
We assess the profile using Ricketts line, which connects the tip of the nose to the chin. With the chin now in its correct position, we can see that both lips could be projected slightly more to achieve balance. The approach is a bolus technique, using a 27-gauge needle and Revanesse Kiss gel. The lips are divided into 12 compartments. By allowing the gel to flow into these compartments rather than creating multiple threads, we reduce trauma and pain. The bevel of the needle faces forward, and we inject into layer two, flattening the lip. The gel then flows naturally, filling the compartment. You can see the gel move across the upper lip with just a gentle massage. The result is a cohesive structure, not a collection of lumps.
This technique is counterintuitive—many would reach for a smaller gauge needle, but a 27-gauge allows for better anterior flow and control. Patients consistently report less swelling, less bruising, and no lumps. The key is to be in the right depth. The vessels in the lips are typically deep, beneath the orbicularis oris muscle. In roughly 2% of cases, a vessel may be within the muscle, and in less than 1%, it sits superficially near the wet-dry border. By staying superficial in the subcutaneous plane, we are almost always safe. Slow injections, controlled placement, and watching the skin further reduce the risk of vascular adverse events.
After the main boluses—0.5 ml in total—we add tiny finishing touches. Micro droplets of gel are placed where contour irregularities appear, blending the transitions. The lips are then massaged firmly with a disinfectant-soaked gauze to create a convex shape. This step cannot be rushed. The final result: the same shape and structure, but with additional volume to the core tubercles. Swelling will subside over 4 to 5 days, and the final result is seen in 2 weeks.
Bringing It All Together: The Full Treatment
The complete treatment involved several stages. First, the temples were treated with a needle and Revance Shape. Then, the lateral cheek fat was addressed with Revance Contour using a 22-gauge cannula, half a syringe per side. The zygomatic arch was sculpted with additional contour, with volume placed beneath the muscle and fanned out laterally in the subdermal plane. The chin line was treated to push the chin downward and across the labiomental crease, creating a beautiful feminine taper. Finally, the lips received the bolus technique with Revanesse Kiss and a few refinement injections.
Six weeks later, the patient returns. The recovery was smooth, with minimal downtime. She is most pleased with the lips—a result that exceeded her expectations. The cheeks have a nice definition, and the chin completes the jawline perfectly. The lips are balanced, even, and natural. There are no nodules or lumps. When the lips are stretched, the product is evenly distributed. The projection is still well behind the line between the nose and chin, creating a harmonious profile. This is the power of a systematic, evidence-based approach: a result that feels like a natural enhancement, not a transformation.