Can Chin Filler Affect the Bone Underneath?

Yes, it can, at least in some people. A 2024 study using CT scans found that hyaluronic acid filler placed on the chin bone was followed by a small, measurable loss of bone surface in about a third of patients within a year, though the researchers saw no effect on appearance or teeth during that time.

Why this was studied

Chin filler is a popular way to add projection or balance a profile without surgery. For years, surgeons have known that solid chin implants can slowly press into the bone beneath them. Scattered case reports have raised the question of whether filler, which is soft but sits directly on the bone, can do something similar.

Until recently, most of that information came from isolated scans. A team at a plastic surgery hospital in Beijing set out to measure the question more carefully, comparing people who had chin filler with people who had not.

What the researchers did

The study had two parts. In the first, 39 people having chin filler and 39 comparison patients had CT scans of the jaw before treatment and again six to twelve months later. The people reading the scans did not know who had received filler. The filler was a hyaluronic acid product placed deep on the bone at the front and bottom of the chin, with some placed under the skin beside it. Volumes ranged from just under 1 mL to 4 mL.

In the second part, the team looked back at scans from 95 people who had already had chin filler and 95 matched comparison patients.

What they found

In the forward-looking group, the bone surface of the chin was measurably reduced after filler, while the comparison group showed essentially no change. On visual review, about 36% of filler patients (14 of 39) had clearly visible bone loss, 12 had subtle changes, and 13 had none or uncertain findings. The bone loss mostly appeared in two shallow hollows on either side of the lower front of the jaw.

Interestingly, people who received more than 1 mL did not show more bone change than those who received less. The look-back group showed a similar pattern, with lower bone measurements in the filler group than in controls.

Importantly, the researchers found no damage at the roots of the lower front teeth and no worsening of chin appearance during follow-up. They described the changes as far milder than the erosion seen with chin implants. Only one minor bruise was reported as a side effect.

How strong is this evidence?

This is a well-designed study for its type: it had a comparison group, used blinded scan readers and measured bone directly. But it was small and was not randomized, and the comparison patients were people having other facial surgery, which is not a perfect match. All patients were treated at a single hospital with one filler product and one injection pattern, so results may not apply to every product or technique.

The biggest open question is what happens over the long run. Follow-up was at most a year. No one yet knows whether the bone recovers once the filler breaks down, or whether repeated treatments over many years add up. The authors call for a larger randomized trial.

What it means for you

This research is a reason for informed consent, not alarm. Chin filler remains a reasonable option for many people, and the study did not show harm to appearance or teeth in the short term. But it is fair to know that filler resting on bone may cause the bone surface to remodel a little.

If you have had repeated chin filler over many years, or plan to, it is worth discussing how much product is truly needed and how often. The authors suggest that people having serial treatments might benefit from imaging after several sessions, though there is no agreed guideline on this yet. For some people, particularly those with a significantly recessed chin, a surgical opinion may be worth considering alongside filler.

Our article on jawline and chin filler covers what to expect from treatment, and how long filler lasts explains why some products linger longer than expected.

Chin filler is not for everyone. People who are pregnant or breastfeeding, have an active skin infection or cold sore near the area, or have certain immune conditions are usually advised to wait or avoid treatment. The usual risks of chin filler include swelling, bruising, lumps and, rarely, blocked blood flow.

Questions to ask at your consultation

• How much filler do I actually need, and how deep will it be placed?
• How many treatments have I had in this area, and is a break sensible?
• Would a surgical opinion suit my goals better?
• What should prompt me to have the area checked by imaging?

Putting the numbers in perspective

A measurable change on a CT scan is not the same as a visible change in the mirror. Scans can detect very small differences in bone surface that a person would never notice. That is useful for research, but it means these results should be read as an early signal to monitor, not as evidence of harm.

Frequently asked questions

Will chin filler make my chin smaller over time?

The changes measured in this study were small and did not affect appearance during the first year. Whether larger effects appear over many years of treatment is not yet known.

Does dissolving the filler stop bone changes?

That has not been studied. It is reasonable to think pressure would ease once filler is gone, but whether the bone rebuilds is an open research question.

Does this happen in other areas, such as cheeks?

Bone changes under filler have been reported elsewhere in case reports, but this study looked only at the chin, so it cannot answer that question.

If you are considering chin filler or have had several treatments already, a consultation is a good time to review your history, your goals and whether more product is the right choice.

Source

Guo X, Zong X, Song G, Zhao J, Lai C, Zhang D, Jin X. Would hyaluronic acid-induced mental bone resorption be a concern? A prospective controlled cohort study and an updated retrospective cohort study. International Journal of Surgery, 2024. Read the study