• Lexi Abi-Khattar

Do people that get jawline / midface fillers need epigenetic orthodontics or orthotropics treatment?

Updated: Jul 14

Jawline fillers and midface fillers (as well as PDO threads) have been increasingly popular in order to achieve a contoured jawline and cheek as we see in celebrities like Angelina Jolie, but is there an underlying reason why people find the need for these types of procedures in the first place?

If you browse the before photos of the various patients who get jawline or facial enhancement with fillers and even PDO threads, there are common similarities that you will notice of their facial profiles. The similarity is a receding jawline and the desire for "more definition and contouring." This receding jawline, as seen in the before photo below from Derm Collective, is indicative that this patient potentially has an underlying craniofacial deformity related to an underdevelopment in the maxilla bone.

Many people believe bone structure is part of one’s genetic inheritance and therefore, it is set in stone. However, there are many epigenetic factors that can influence

craniofacial structure and development over time: posture being a significant one. People are looking down at their smart phones all day, which overtime can cause a forward neck posture. Additionally, the development of the facial structure can be influenced by the position of the tongue in the mouth from an early age. For example, if a baby is born with a tongue tie that goes unnoticed by doctors, there is a high probability this person will grow into an adult with an underdeveloped maxilla bone (the region in green in the photo to the right), which means their bones and craniofacial structure didn’t reach their genetic potential due to environmental influences that favored a downward facial swing instead of the intended

default: forward facial development. Not only is the latter more attractive in appearance, but it also allows for more tongue space, larger airway volume, improved nasal breathing and oxygenation.

Forward facial development and contouring is exactly what the jawline fillers help these patients achieve. While skin injections may enhance appearance and give the patient a temporary dopamine boost, they will not address the root cause of why people choose to get these procedures done in the first place. Our society is hung up on decreased skin elasticity and volume, but bone density is also key to looking young. A receding jawline (bone loss in the jaw) that brings people to a plastic surgeon’s office is correlated with obstruction in the nasal airway, a deviated septum, chronic mouth breathing, allergies, jaw joint issues, TMD (temporomandibular joint dysfunction) and sleep disordered breathing/ sleep apnea. This leaves the opportunity for plastic surgeons to integrate with epigenetic orthodontists, biological dentists, myofunctional therapists and ENT surgeons to ensure their patients are getting their medical needs met (as well as their aesthetic needs).

Dr. Mew has an Orthotropic/ Epigenetic orthodontics practice in London, where he helps his adult and child patients achieve forward facial growth and proper jaw position without surgery. As you can see in the before and after photo below, the results

resemble patients receiving facial fillers. In the after photo, you can see prominent jawline and chin definition and improved projection of the maxilla bone and mid cheek as compared to the before photo. Fillers are a quick superficial "fix," but in the case with Dr. Mew’s patients, the changes are occurring at a deeper level amongst the bones, while also addressing functional changes to allow for proper tongue posture, improved airways, nasal breathing, ideal chewing and swallowing and improved oxygenation. Patients of Dr. Mew's and other doctors that use this type of treatment (not the mainstream orthodontic treatment), will achieve improved overall health and enhance their appearance, while patients who get fillers may still suffer of the underlying craniofacial deformities, malocclusion and airway obstructions.

Don't get me wrong, there may be people who seek out cosmetic procedures that are medically fine without any underlying issues. However, since the before photos indicate maxilla underdevelopment as being the cause of the lack of forward facial projection, it doesn't hurt to assess a cosmetic patient for any underlying medical issues or refer them to a specialist that can help address these problems if necessary (airway obstruction, tongue tie, TMD, underdeveloped maxilla, deviated septum, etc.).

There is nothing wrong with wanting to improve the way you look, so no judgement to anyone seeking enhancement options. Afterall, it isn't a coincidence that people find the after photos to be more attractive- it is hardwired in our DNA to be attracted to this type of form, as it is correlated with health and fertility.


https://pubmed.ncbi.nlm.nih.gov/24658014/ Relationship between nasal obstruction and jaw maturation


Relationship between nasal obstruction and decrease in bone density of mandible and alveolar bones

https://www.drstevenlin.com/adult-orthodontics-facial-symmetry-sphenoid-bone/ Relationship between maxilla, tongue and airway

https://orthotropics.com/john-mews-lecture-part-10-measuring-facial-aesthetics/ Orthotropics, facial shape, cheek line

https://pubmed.ncbi.nlm.nih.gov/28119621/ Nasal obstruction and craniofacial changes

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