Jawline augmentation: the important final piece in restoring balance in the ageing face

The use of soft tissue fillers to restore volume to the face and tackle the signs of ageing continues to be on the rise. According to the American Society of Plastic Surgery (ASPS), injectable fillers were used in 2.69 million procedures in 2017 (ASPS, 2018). This is up three percent from 2016 (ASPS, 2018). Aesthetic nurses have become much more skilled in replacing volume to restore the balance of the face, rather than filling creases. Many advances were made in the field with the understanding of midface augmentation to replace volume lost in the lateral malar and apex regions of the cheek to lift the nasolabial fold and lower face area. However, more recent understanding of the effects of restoring the jawline have given consumers a much higher rate of satisfaction in nonsurgical facial rejuvenation.

In order to understand how to restore this natural balance, it is important to understand the changes that are happening in the ageing face. The intrinsic factors that contribute to the ageing process are ones that show the most effect on the lower face and jawline. The ageing craniofacial skeleton is not only a result of bone atrophy, but also of the changes in the height and width of the face, as some bones expand and some lose mass over time. An increase in facial width and depth may be noted due to changes in the maxilla and mandible, as is a decrease in facial height. Mandibular changes are noted with any loss of teeth which causes marked resorption of the alveolar ridge and shape, and projection of the chin will also change with age. There is a general coarsening of mandibular bony protuberances at the points of insertion of masticatory muscles and a general softening elsewhere.