A Treatment Guide for a Weak Chin

A strong jawline is a coveted feature for both men and women.

The end goal may be different between men and women, with men preferring a strong angular angle of the jaw, border, and chin, and women aiming for a softer yet defined jawline.

In this guide, you’ll learn about what treatments are best for a weak chin or asymmetrical jaw.

Jowls are the bane of the aging face, no matter what the sex. Also, depending on your skin’s innate characteristics, lifestyle, environment, and weight changes, jowls can appear as early as the 30’s.

When evaluating the face, it is often assessed in 1/3’s. The lower third of the face extends from just under the nose, to the chin.

Looking at the lower face as a whole, there are certain key elements to a beauty.

Starting from the bottom up:

1. Cervicomental Angle
2. Proportionate Chin
3. Sharp Jawline
4. Lack of Jowls
5. Defined Jawline Angle
6. Lack of Marionette Lines or Folds
7. Upturned Corners of the Mouth (Oral Commissures)
8. Smooth Skin on the Upper Lip
9. Moderate Full Volume in the Lips
10. Philtral Column Definition

What we can do about these areas:

Cervicomental Angle

Nice cervicomental angle, which is the angle formed from chin to neck. Short of addressing the neck itself, there are ways to create the illusion of a longer neck and better contour by making a strong jawline and the chin shows good projection.

Proportionate Chin

Appropriately proportioned chin from all angles. From the front- not too big, not too small, not too long, not too short; From the side- not jutting out too far forward or set too far back (retrognathia); Overall- not too small (micrognathia) or too large in relation to the rest of the face.

When looking at a side profile of a face, you generally want the upper lip and chin to stick out to the same degree. If it doesn’t, then filler can be added to increase the projection until they match.

On a side note, a weak chin that lacks projection gives the impression of having a big nose, when it’s really not the nose at all. It only looks big in relation to the tiny chin. Once you fix a weak chin, the nose suddenly looks smaller and the face looks more balanced and more attractive.

This is also why often when a patient goes in for a nose job consult, they end up getting advice on the nose and chin, not just the nose.

To address size or projection, the options are basically fillers, chin implant, or less commonly fat transfer to the chin. Chin fillers are the least invasive option. They are temporary, take effect immediately, and have nearly zero downtime (bruises are rare, and fade away in about 7-10 days if they do happen).

Chin Fillers

It’s a fantastic option for those who want to “try out” what chin augmentation would look like, don’t want surgery, don’t have time for surgery or for recovery from surgery, or don’t have the funds for surgery.

The type of filler used is critical here because it needs to be thick enough and have a large enough particle size to make a difference in projection (if thin and runny it would spread out rather than stay and give projection) and one that lasts longer than the short acting fillers.

Chin Augmentation

The surgical option is a chin implant, and involve the placement of silicone implants in a precise pocket along the chin for augmentation. The implants come in different sizes, and are implanted through a small incision, either inside the mouth, or under the chin (preferable incision in my opinion).

There is a risk of nerve damage during placement, and also asymmetry. Keep in mind all faces have some degree of asymmetry, and if the chin is starting off asymmetric, there may be persistent asymmetry even after an implant.

Fat Transfer

A third alternative to chin augmentation is using fat in place of either fillers or implant. Critics of this procedure point to the general plastic surgery principle of “replace like with like”, and feel that fat over the chin will never feel like bone, and will also not achieve as good of an aesthetic result.

Sharp Jawline

Clean, well defined jawline. In some people, the lower cheek seems to blend into the neck without any defined start or end. In other people, what was once a strong jawline gets obscured by jowls, which instantly age the face.

Lack of Jowls

Jowls result from a combination of the effects of gravity on fat pads in the face, and decrease in skin elasticity that comes with age (or massive weight loss). The best way to handle jowls is facelift surgery.

But… in the meantime, there are non-surgical ways to camouflage sagging jowls or make them less jowly. Fillers for jowls is injected to the little indent in front of the jowl (“prejowl sulcus”), and have to be done from below to effectively smooth the area. If injected directly above the little notch, the filler actually sits too high to make a difference.

Other non-surgical treatment for sagging jowls include things like radiofrequency skin tightening, or ultrasound skin tightening.

One other option that I do not recommend is a thread lift.

The reason I don’t love this option is the thread lift complication of weird lines of pull seen when animating the face (smiling or making other expressions), the puckering or dimpling (usually temporary), risk of exposure of the threads, and the scar tissue left behind even when the thread itself is temporary.

Let’s just say the newer threads have not been used enough for me to be satisfied saying both the short term and long-term risks are minimal.

Defined Jawline Angle

Smooth transition between the above features. This is accomplished through fillers mainly, when and where needed. Jaw angle implants is a surgical option.

Lack of Marionette Lines or Folds

Well supported area between chin and lips. No marionette lines or grooves (depressions running from the corner of the mouth towards the chin).

Neutral or Slightly Upturned Corners of the Mouth (Oral Commissures)

Neutral or slightly upturned corners of the mouth (oral commissures) are a sign of a youthful mouth. As the mouth ages, and marionette lines develop where there is loss of support under the corners of the mouth, the corners fall and can look like a perpetual frown. Frown lines can make one look grumpy or angry, and correcting this area gives an instant look of happiness and youth. Fillers to this area can literally turn the frown upside down.

Even when people recognize that the mouth region looks like it has aged, most are unaware of or don’t notice the lack of support under the corners of the mouth, resulting in what we call marionette lines (puppet lines around mouth).

Adding filler here is not meant to add bulk. It is meant to restore lost support, and simply by doing this the entire mouth region looks better and younger. It is also an area that still benefits from filler even after a facelift.

The important thing to note with facelifts is that they are the best way to reposition the facial tissues, but they do not take the place of fillers, Dysport or Botox.

Smooth Skin on the Upper Lip

Smooth skin around the mouth, no fine lines called smokers lips or vertical lip lines or along the sides call laugh lines. I may differ from many others out there when I say I do not love filler to these lip lines.

I think repeated filler to these lines end up giving the upper lip that fat, thick lip look that you never see in nature. It is unattractive and hard to reverse.

Instead, my favorite ways to treat this area are with a custom combination of rf skin tightening (using a small enough handpiece to go around the mouth), fractional laser resurfacing, peels, and growth factors in skin care and / or stem cell skin care.

Moderate Full Volume in the Lips

Overly thin lips can look shriveled and aged, and overly artificially plumped lips look obviously altered. What is the best answer? Almost everyone could benefit from a very small amount of lip fillers, to restore volume lost over time.

I prefer to add volume to the vermilion border, or pink part, or pulpy part of the lip, and do a conservative treatment along the borders (Personally I like to inject filler only within the lip borders. Injecting the white roll gives a very done look).

Philtral Column Definition

Gently defined philtral columns (space between nose and lip). With age the little ridges that run from the base of the nose to the top of Cupids bow flatten, and augmenting these has a noticeable anti-aging effect here.

The reason I say “gently defined”, is because this area can look artificial and strange if too much height is built up with the use of filler. Also, in most people these columns are not straight, they are slightly angled, and the injector doing the filler needs to recognize this so a weird look is not created.

It should also be subtle enough that it does not look weird when speaking or smiling or chewing.