Hyaluronic acid fillers in the labiomental sulcus to reduce apparent chin prominence in class II hypodivergent patients: a retrospective clinical study.

BACKGROUND

Hyaluronic acid (HA) fillers are commonly used for facial augmentation and contour enhancement, particularly to improve deficient skeletal projection. Their application to reduce the perceived prominence of the chin has not been previously reported. The aim is to describe indications, technique, safety, and aesthetic outcomes of HA filler injections into the labiomental crease for camouflage of apparent chin protrusion in selected patients.

METHODS

This retrospective study included 24 female patients with skeletal Class II hypodivergent profiles treated between 2019 and 2024. High-elastic modulus (G'>300 Pa) cross-linked HA fillers were injected intradermally into the labiomental sulcus using a linear retrograde threading technique. Clinical and photographic evaluations were performed at 1, 3, and 6 months. Patient satisfaction was assessed using a 10-point Visual Analog Scale (VAS).

RESULTS

All patients completed follow-up. Mild, transient erythema and edema occurred in all cases and resolved within 48 hours. Temporary blanching was observed in 12.5% of patients and resolved spontaneously. No severe or delayed adverse events were reported. Treatment resulted in consistent softening of the labiomental crease, an augmentation of the labiomental angle, and improved lower facial harmony. Mean VAS satisfaction score at 6 months was 8.7. In selected patients, results remained stable for up to 36 months.

CONCLUSIONS

Labiomental crease injection with HA fillers is a safe, effective, and predictable minimally invasive technique to reduce perceived chin prominence in selected Class II hypodivergent patients, expanding the conceptual use of fillers beyond augmentation alone.