Medical and surgical therapeutic strategies in the aesthetic defects of the chin

Introduction The chin region is the terminal part of the lower third of the face and appears to be of considerable aesthetic impact in the overall harmony of the face: a well proportioned chin contributes to have a pleasant definition of the profile. More common aesthetic defects are : low    projection (hypomentonism) or excessive (hypermentonism), asymmetry, or signs of aging  in the so-called “witch’s chin”, characterized by accentuation of the submental groove and ptosis of the soft tissues, in association with increase or reduction of the projection.

Materials and Methods – Our first aproach to such aesthetic defects is generally a medical treatment using fillers. We use  long-lasting fillers (Calcium hydroxyapatite, Polycaprolactone) injected    deeply at the level of the periosteum and at the half depth, subcutaneously. When a surgical treatment is indicated we use standard or extended silicon implant, in a submental pocket  above the mental bone and the mandibolar line. Hyperprojection of the chin is always corrected surgically by reducing soft  tissues and, if necessary,  the  bone by a drill.

 Results – Using  injected matherials we obtain a good improvement of the profile as well as of the skin surface and texture,  with a minimally aggressive procedure, but the  disadvantage  is the variable reabsorption and, consequently,  the need to repeat it.  The surgical treatment is definitive and chin implants  provide an optimal projection,  but the procedure is more aggressive and includes the risk of complications related to the implant.

Conclusion – The treatment of aesthetic defects of the chin can be medical or surgical. In our own cultural baggage it is necessary to have  various techniques in order to solve our clinical cases in the best way.