How To Remove Cleft Chin

Dr Gabriel Siquier Dameto discusses the bewitchery, characteristics and various treatment methods for a cleft chin

What is a cleft mentum?

A fissure chin refers to a chin with a Y-shaped dimple in the middle.¹ It'southward usually a ascendant genetic trait. Cleft chins form during embryological development and are caused by one of the following bug; either the mandibular processes take not fused properly at the level of the mandibular symphysis which created an indentation,² or the chin muscles, known as the mentalis muscles, on both sides of the dimple are further apart than normal, effectively pulling in the pare effectually the chin surface area.

In the vast majority of instances, chin clefting is caused by how the mentalis muscles are situated. The mentalis is a paired central muscle of the lower lip, situated at the tip of the chin. It originates from the chin and inserts into the chin soft tissue. The mentalis is located in the triangular space that delimits the depressor musculus of the lower lip on both sides of the midline; between the upper role of the symphysis and the mental eminence. It is even, small and conoid. The mentalis is inserted on the upper part in the lower maxilla below the incisive eminences and the canine, below the gums; and in the lower function, at the skin of the mentum.³

In the case of a cleft mentum, at that place is either a wide space between the two mentalis muscles or they are particularly large, creating a 'valley' of sorts between them.

Attractiveness of a cleft mentum

Cleft chins are often considered a sign of attractiveness and dazzler, also as a sign of power. In Persian literature, the mentum dimple is metaphorically referred to as 'the chin pit' or 'the chin well'; a well in which the poor lover is fallen and trapped.⁴ But the appreciation of beauty is, almost of the time, dependent on personal preferences and style. As such, there are individuals who don't like the cleft chin as it can be seen equally a rude feature in men or as a masculinising characteristic in women; in this way a scissure chin tin sometimes be referred to as a 'butt chin' with derogatory connotations.

Differences in cleft chins between men and women

There are some differences regarding how the cleft chin presents in men and women. Generally, the dimple in men is deeper and wider, forming vertical and Y-shaped furrows. In women however, the dimple ordinarily appears less deep, softer and centered, forming round dimples. This is due to the fact that normally the inferior maxilla of a women is smaller than in men.

Treatment methods

Before performing a treatment to heighten or to remove a cleft mentum it is important to consider the risks associated with the treatment, to be explained futurity. Different treatment options are offered, largely depending on whether the patient wants to accept a temporary or permanent result. Temporary results can be achieved with various fillers and injectables, if the patient is willing to undergo surgical options then the result volition of course be permanent. This article will focus on removing the cleft chin rather than enhancing, which is a less pop treatment, usually to assistance with the appearance of ageing.

Mentum fillers

The easiest and most direct fashion to remove a scissure chin is simply by placing hyaluronic acid (HA) filler into the chin area. HA fillers can be injected directly into the dimple, finer raising the pare in the dimple area to bring it into proportion with the rest of the mentum. To achieve this lifting effect and to replenish the arrears of tissue book in the chin, a high viscosity filler must be used. This will guarantee a longer lasting result and plenty lifting capacity.

The HA filler is injected with a needle directly onto the maxillary bone where the dimple is located. Filler must be injected with the bolus technique. I would recommend practitioners inject 0.1 ml while counting to 10, this is mainly to avoid complications as slow injections and pocket-sized boluses tend to exist safer. Then, while retracting the needle, continuously inject the product in guild to create a sort of pyramidal bolus. Two farther injections can exist administered to the lower corner of the mandible at a 1cm distance from the medial facial line to lengthen the face or visually expand the chin.^v The insertion point is at the lower jaw corner directly inferior to the corner of the oral cavity. If necessary, some extra product can be placed subdermally with a cannula and fanning technique. In this fashion, the surface is smoothened to achieve a more natural final expect. The quantity of product normally needed for a fissure chin treatment can vary betwixt 1 to 3ml of HA filler. Sometimes, if the dimple is very deep, or in case of mentalis hyperactivity, I believe information technology is exist better to conduct the treatment in two sessions with a one month interval. In clinic, I prefer to do a dosage control of botulinum toxin, which I go along to hash out in more than detail beneath, after i month to come across if a top up is fifty-fifty necessary. It also helps to monitor any swelling or complications.

Although HA fillers are a quick and mostly safe option, the results volition not be permanent and the effects will concluding for effectually 12 months. It is wise to suggest the patient to have a top-up session every eight months in order to achieve continuous results.

Botulinum toxin injections

Botulinum toxin is a purified toxin that blocks the nerve signals from the brain to the muscle;^six this results in the relaxation of the muscles. Equally previously mentioned the cleft mentum can be formed because of the depression betwixt the two mentalis muscles and botulinum toxin can paralyse these muscles, consequently reducing the appearance of the cleft. The effects of botulinum toxin, nevertheless, only last for around iii to six months depending on the private and it will not have the filling capacity. On the other hand still, it is a good ally to complement the HA filler treatment.

Surgical options

At that place are also other options to treat the cleft chin such every bit fat grafting or surgery. These treatments tin have a longer lasting upshot merely they also need more recovery time and they can have more serious complications such equally infection, excessive haemorrhage, scarring, swelling or undesirable results. When performing fat grafting it has to be considered that the size of the mentum will be increased and some patients will not be happy with this new appearance. Surgical solutions to correct a fissure chin can involve chin implants, modifying the chin bone itself and addressing the placement of the mentalis muscles, or a combination of these last ii options.

Whichever handling the patient may choose, surgical or not-surgical, it is important to keep in mind that it is nearly impossible to reverse a especially prominent scissure chin by only one type of treatment. Personally, my preferred handling is a combination of HA filler with botulinum toxin. In my opinion this is less invasive, with reduced or no downtime for the patient and immediate results.

Preventing complications

Equally with all kinds of filler treatments, understanding and respecting the anatomy of the treated area is very important. Early and late complications with varying levels of severity otherwise may otherwise occur. For instance, an intravascular injection tin can crusade the development of local peel necrosis, a massive microcirculatory embolism and/or external pinch of the mentum skin microvasculature. Another complication recently published is a vascular compromise in the tongue.⁷ This occurred later on chin augmentation with HA. The filler was possibly injected into the sub-mental avenue or its branches, which then was most likely to accept travelled to the deep lingual artery, before causing the vascular compromise.

In the example of suspecting a sign or presence of vascular compromise, hyaluronidase must exist injected immediately to the treated expanse and the compromised expanse. To avert vascular events, my professional person opinion is that injection techniques such every bit utilise of a blunt cannula, slow injection, depression-force per unit area injection, moving the needle while injecting, and apply of a small bolus per injection should be applied.

Decision

Although more than permanent results for treating the scissure mentum tin exist achieved through surgical options, I believe that a combination treatment of HA filler and botulinum toxin will have a much more positive, less invasive arroyo. I recall information technology is also of import to brand patients aware that cleft chins are often perceived equally a sign of beauty throughout the world, which is another reason to recommend filler treatments every bit they don't concluding forever. Every aspect of the treatment should be discussed in the consultation to ensure the patient is suitable, it may also be worthwhile to carry out a torso dysmorphic disorder (BDD) test if you are initially concerned. Possible complications that could occur should likewise be discussed.

Source: https://aestheticsjournal.com/feature/treating-a-cleft-chin

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