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Jawline Contouring Treatment with Injectables

Use of injectables can produce jaw-dropping results.

Kim Nichols, MD, FAAD; Emily Anne Scalise, MBA; Vanesa Kodra, MS, PA-C; and Madison Bradley, BS

Enhancement of one’s side profile has been one of the most desired treatments within the cosmetic world. The key to an aesthetically-pleasing side profile is a more defined and contoured jawline. Jawline contouring has become one of the most popular trends of 2021, and this has proven to be true at NicholsMD of Greenwich. Just take a look at #jawlinefiller on Instragram; you will find more than 354,000 posts. We have developed a Signature Jawline Contour treatment as a non-surgical cosmetic procedure that aims to elevate and define the jawline. This customizable treatment package uses a variety of injectables, including calcium hydroxylapatite, hyaluronic acid fillers, and neurotoxins. The Jawline Contour treatment is based on each patient’s individual needs and is customized to achieve their desired outcome.

THE BOTTOM LINE

With age, loss of definition in the jawline area is common, due to skin laxity, bone resorption, and fat atrophy. Both male and female patients request chiseled, contoured facial features for a stronger side profile and a contoured jawline. The customized use of injectables, including calcium hydroxylapatite, hyaluronic acid fillers, and neurotoxins, can produce the desired outcomes in a minimally invasive way.

BACKGROUND

As we age, loss of definition in the jawline area is commonly seen due to skin laxity, bone resorption, and fat atrophy. The change from a soft, contoured, oval-shaped, “youthful” looking face, to a sagging, jowly, square-shaped appearance is a natural effect of these skin and volume changes. Chiseled, contoured facial features are also requested by our younger male and female patients for a stronger side profile and a contoured jawline. The Jawline Contour treatment is a procedure where dermal fillers are injected into the jawline to instantly lift the skin, sculpt, and define the angles of the lower face, improve volume, restore overall balance and symmetry, and improve a patient’s “selfie” profile.

All treatments at NicholsMD begin with a detailed consultation assessing the patient’s facial and neck structure from top to bottom. The Jawline Contour treatment is uniquely created to address patients’ concerns of lower face sagging and their desire for a more beautiful side “social profile.” Depending upon the patient’s lower face concerns, our signature jawline treatment plan may include calcium hydroxylapatite (CaHa; Radiesse, Merz) filler to lift and support the bilateral rami, hyaluronic acid filler to define the chin area, neuromodulators to slim the masseter muscles and/or soften perioral muscles, and deoxycholic acid (Kybella, Allergan Aesthetics) injection in the submental region to permanently reduce small areas of fat under the jawline and chin.

PATIENT EVALUATION

At NicholsMD, we perform an assessment and aesthetic evaluation of a patient prior to treatment. We show the patient digital photos we have taken of them on a tablet. These photographs include three fundamental angles: head-on shot, 45-degree angle, and 90-degree angle. Unlike handing the patient a mirror, the tablet photos allow them to truly see what they look like at different angles and profiles. Sitting side-by-side with the patient, our providers can point to various features of the patient’s profile that can be improved with our customized Jawline Contour treatment. Patients are then counseled on the mechanics of the treatment itself, that they can expect to see optimal results approximately one to two weeks post-treatment, and that results last 12-24 months, on average. We also review post-care instructions and possible side effects. Consent is signed by our patients after thorough review and counseling of potential risks and recovery period. Dr. Nichols and her dermatology physician assistants also create a customized, in-depth skincare regimen for each patient to prevent aging and maximize results at home. Lastly, we advise our patients to schedule a nine-month follow up appointment in order to assess satisfaction and review potential next steps.

Candidates for the Jawline Contour treatment are patients who have mild to moderate jowls, those who desire increased definition in their jawline, patients who report sagging in their lower face, and those who complain of a double chin. This procedure is key to providing more length and dimension overall in a patient’s face. This combination treatment is so popular with our patients because it is non-surgical, results are fairly immediate with minimal recovery time, results are long lasting, and the treatment is suitable for both men and women.

INJECTION TECHNIQUE

The FDA has approved calcium hydroxylapatite as an injectable filler for tissue augmentation of the jawline. When restoring an oval jawline, CaHa provides an unmatched ability to attain instant and long-lasting volume amplification, due to its higher elastic modulus (G prime) and viscosity, as compared to several hyaluronic acid fillers. Last year alone, there were more than 200,000 patient requests for calcium hydroxylapatite usage for soft tissue fillers.1

To recontour the jawline, we inject calcium hydroxylapatite using a hypodermic needle or blunt-tip microcannula. Generally, CaHa is injected with a 30mm-long 27gauge inner diameter needle or 22 or 25gauge variable length microcannula. The choice of needle or cannula should reflect provider preference. Calcium hydroxylapatite is injected along the periosteum of the inferior mandible. A retrograde linear threading technique is used in the submandibular and lateral mandibular placement. A second insertion point is made at the intersection of the jawline and lateral chin. A retrograde linear threading technique is then used for submandibular and lateral mandibular placement. The total volume of filler used during treatment varies for each patient, individually. Adverse events associated with calcium hydroxylapatite include redness, swelling, and bruising. As with any procedure entering the surface of the skin, there is a risk of infection. Performing the procedure in a sterilized field minimizes risk.

The injection of calcium hydroxylapatite can be combined with other aesthetic treatments, including hyaluronic acid fillers, neuromodulators, chemical peels, as well as laser resurfacing treatments. At NicholsMD, patients are provided with written aesthetic treatment plans that are catered to their specific concerns, along with a timeline of when to schedule such treatments to maximize results.

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CONCLUSION

The “NicholsMD Signature Jawline Contour” leaves patients overjoyed about the definition in their jawline and the elevation and slimmed appearance of their face and neck. The selection of calcium hydroxylapatite as an injectable filler in the jawline is ideal for patients seeking a contoured jawline or those experiencing age-related volume loss in the lower face. In addition, because it also stimulates neocollagenesis, it can help improve the overall quality and attractiveness of the patient’s skin. A well-defined jawline is desirable in all our patients, giving a perception of beauty and youth.