Lexi Abi-Khattar
Do people that get jawline / cheek fillers need epigenetic orthodontics or other dental treatments?
Updated: Mar 21
Injectable fillers have been increasingly popular in order to achieve a contoured jawline and cheekbone as seen in celebrities like Angelina Jolie, but is there an underlying reason why so many are seeking these procedures? The similarities amongst patients requesting dermal fillers tends to be a receding jawline and flat cheekbone. Receding jawlines and flat cheekbones are indicative of underdeveloped maxilla and mandible bones, which should ideally give the face a forward protrusion when developed and positioned properly.
This receding jawline, as seen in the before photo below from Derm Collective, is indicative that this patient has an underdeveloped maxilla and mandible, leaving little room for the tongue and a narrow airway, which can lead to obstructive sleep apnea.

Many people believe that bone structure and facial appearance are genetic; however, there are many epigenetic factors that can influence the structure and development of the skull

over time. For example, chronic nasal congestion amongst children exposed to allergens leads to chronic mouth breathing, which causes bone loss in the maxilla (bone in green in the photo to the right) during a crucial period of growth and development. This type of environmental influence will cause a downward facial swing of the jaw instead of the intended forward facial development. Not only is the latter more aesthetically appealing, but it is also correlated with nasal breathing, a larger airway and improved oxygenation for the entire body.
Forward facial development and contouring is exactly what the jawline fillers help these patients achieve. While filler 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. The plastic surgery industry sells solutions for decreased skin elasticity and volume, but bone density and position of the bone are key factors for the sought after youthful and taught look. Since injections only address superficial areas underneath the skin, this leaves the opportunity for plastic surgeons and other injectors to integrate with epigenetic orthodontists, biological dentists and ENT surgeons to ensure the underlying medical conditions of their patients are also being addressed. A receding jawline due to the position of the mandible and maxilla being positioned further back 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.
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. Patients who only get fillers may still suffer from the underlying 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, 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.
There is nothing wrong with wanting to improve the way you look, so no judgement to anyone seeking enhancement options. After all, it is hardwired in our DNA to be attracted to this type of form, as it is correlated with health and function. If you want to improve your breathing, health and facial appearance click here.
Sources:
https://pubmed.ncbi.nlm.nih.gov/24658014/ Relationship between nasal obstruction and jaw maturation
https://www.sciencedirect.com/science/article/pii/S1991790221001069?via%3Dihub
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