Figure 5.

Mandibular augmentation. As bone resorption is most apparent at the dorsum of the mandible, at the mandibular angle, the cannula entry point for mandibular augmentation should be placed at the dorsum of the mandibular angle.22 From there, the cannula should be advanced at the level of the dermal-subdermal junction to the pre-auricular area, from where a fanning technique can be used with diluted Radiesse for easier spreading of the product (in this case 0.8mL lidocaine per 1.5mL Radiesse). To enhance definition of the mandible, the first and last thread can be made with more volume (e.g., 0.2–0.3mL). Care should be taken to avoid placing Radiesse into the jowl fat compartment, as this can aggravate the aged appearance. To improve the mandibular area further, Radiesse can be placed in the marionette lines and mental crease via the pre-jowl sulcus entry point as shown.

Left: Before with markings; middle: Before; right: After 1.5mL Radiesse in the jawline plus marionette lines.