16 September 2022

How to achieve a perfect chin line

A strong chin reflects youth, energy, and attractiveness. Often, patients of plastic surgery clinics complain about an unaesthetic neck, a weak chin, and a double chin. All of these common cosmetic problems with the lower part of the face are directly or indirectly related to an insufficiently defined chin line.

What is called an ideal chin line?

A "bulky chin" usually means having a visible border of the lower jaw that runs straight from the corner of the lower jaw to the point of the chin. People with prominent chins have good bone structure, which can only be seen if the skin and fatty tissue are also structurally healthy. Genetics affect the aesthetics of the chin line, and plastic surgery may involve simple liposuction rather than complex jaw surgery. Thus, although creating a perfect chin line is often the desired goal for the patient and their surgeon, multiple operative techniques may be required due to the complex anatomy. There is no single technique that can be used to improve the chin line for all patients. However, with the correct diagnosis, you can use conventional procedures to achieve a clear chin line and an aesthetically attractive lower face. An ugly chin line is seen as a weakly defined border of the lower jaw and/or the shape of the chin, along with laxity or fullness of soft tissues that hide the outlines of bony tissues.

Correct diagnosis and formation of a clear chin line

Diagnosis of each problem allows for the most appropriate treatment. However, not every surgeon can perform orthognathic surgery, however, if the problem can be effectively solved by jaw surgery, the doctor should explain this to the patient before choosing an alternative. Orthognathic surgery is necessary in the case of hypoplasia of the lower jaw, which is a bone deformity of class 2 with or without malformation of the upper jaw. The angle between the chin and the neck is affected by weak tissues under the chin, excess fat above and below the platysma, the position of the hyoid bone, and a protruding lower jaw. With laxity of soft tissues/skin and subcutaneous tissue in the border of the lower jaw, the chin line will also be indistinct. When determining bone morphology, genetics and aging strongly influence the actual shape of the mandible, especially the angle of the mandible, the anterior notch of the ear, and the premaxillary sulcus. The average patient at an aesthetic medicine clinic may complain of a sagging neck, a weak chin, or an inherited neck, unaware of all the potential problems that could be the true source of their complaints.

Methods of forming an ideal chin line

There are proven methods of creating a clear chin line. Each procedure is aimed at eliminating a specific problem. Manipulations with soft tissues:
  • neck liposuction;
  • submentoplasty;
  • face and neck lift.
Enlargement of the lower jaw:
  • chin implant;
  • implants of the angle of the lower jaw;
  • fat transplant or fillers;
  • implants of the outer edge of the jaw (especially non-standard).
Manipulations with bone tissues:
  • BSSO (bilateral sagittal split osteotomy);
  • osteotomy LeFort I (changing the height of the face vertically and, therefore, the position of the chin line);
  • craniotomy
Soft tissue manipulation to address skin laxity, fat distribution problems, and fibromuscular weakness is what most surgeons first consider when a patient complains of an unsightly lower face. In most cases, when the morphology and projection of the bone are normal, procedures with soft tissues effectively solve the problem. Only liposuction is limited because the elasticity of the skin must be good. Submentoplasty with or without a facelift can have a dramatic effect on the angle between the neck and chin, especially if there is abundant subplatysmal fat. If there is laxity directly above the edge of the lower jaw, then a lift of the lower part of the face and neck is necessary. In general, thin patients have an easier time creating an aesthetic chin line after facelift surgery than patients in whom fatty tissue hides the contours of the mandible, regardless of the type of procedure.