Achieving Ideal Lower Face Aesthetic Contours: Combination of Tridimensional Fat Grafting to the Chin with Masseter Botulinum Toxin Injection.

Abstract

Lower face aesthetic contouring is in high demand among Asians with wide and short faces desiring a slim lower face. For this purpose invasive mandible angle reduction and genioplasty are complex procedures with significant risks and downtime. Non-invasive botulinum toxin A injection into bilateral masseters - while popular for lower face contouring - does not address facial length deficiency in wide and short faces. Autologous chin fat grafting is a simple minimally-invasive technique for facial lengthening. We present our experience pairing chin fat grafting and masseteric botulinum toxin injection for effective lower face contouring. Thirteen consecutive patients with relatively wide and short faces underwent chin fat grafting and 1 to 3 serial masseteric botulinum toxin A injections. Mean follow up after final intervention was 20 months (range, 6 months to 3 years). The postoperative mean ratio of bigonial distance to total facial height improved from 0.599 to 0.569 (P < .01), closer to the ideal ratio of 0.561. The mean ratio of upper lip length to lower lip and chin length improved from 0.611 to 0.560 (P < .01), nearing the ideal 0.542. Postoperative lateral profile in all was ideal. There were no complications at follow up. Results were durable at latest follow up and most were satisfied with their final appearance. Combined tridimensional chin fat grafting and botulinum toxin masseteric injection is an effective, simple, fast, inexpensive, safe, and minimally-invasive strategy for aesthetic lower face contouring of short and wide faces, with short downtime, long-lasting results, and high patient satisfaction. 4 Therapeutic.