Chin and jawline filler gone wrong, and only offered surgery? Get assessed first

Chin or jaw filler gone wrong, and offered surgery? Read this first

Patients come to Dr Sin Yong after being told that chin or jaw filler has to be cut out, usually because it is not hyaluronic acid, because it has hardened, or because nobody knows what was injected. Before you agree to an operation, know what it means:

• A scar. Every cut through the skin of the face heals with a scar.
• A dent. Cutting out a lump takes tissue with it, and the area can heal hollow or uneven.
• Nerve injury. Nerves that give the face feeling and movement run close to where filler sits. An injured nerve can leave numbness, or weakness in a smile, a lip or a brow.
• Product left behind. Filler spread through tissue is hard to remove completely.
• No way back. Tissue that has been cut out cannot be put back.

Along the jaw there is more. The marginal mandibular branch of the facial nerve moves the lower lip and runs along the jawline. Its origin and branching are not the same in everyone (Marcuzzo 2020). An injury to it can leave the lower lip weak on one side and the smile uneven. Silicone in the chin is hard to take out completely: the authors of a study of silicone chin granulomas state that complete surgical removal of injected silicone is nearly impossible, because it migrates (Harlim 2026). The facts are set out in surgery for chin and jaw filler below.

In Dr Sin Yong's practice, almost every hard lump is treated without surgery. If yours is one of the few that needs surgery, you are told plainly, and why. He maps the filler with ultrasound, dissolves hyaluronic acid, and treats Radiesse, Ellansé, Sculptra, Juvelook, silicone and mixed products with the Sculpting mode of Time Freeze Laser LCLR®, without an incision. A red, hot or tender lump is treated medically first. Lumps from every kind of filler are covered in hard lumps after filler or skin boosters.

What goes wrong with chin and jawline filler

Most problems after chin and jaw filler fall into a few patterns, and many people have more than one.

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In a systematic review of 8 studies covering 917 people who had hyaluronic acid chin filler, most were satisfied, the commonest side effects were injection-site reactions such as swelling, bruising, pain, redness and itching, 2 relatively major complications were reported, and no vascular complications were reported (Ou 2023). In a randomised trial of hyaluronic acid chin filler in 192 adults, tenderness and firmness were the commonest reactions, and one participant withdrew after a skin infection of the face (cellulitis) and inflammation at the injection site, which resolved (Beer 2021). Problems that last usually come down to how much filler there is, what it is made of and where it sits, which is what the scan shows.

“For hard lumps from mixed products, I use one tool, Time Freeze Laser LCLR®, to target the material without surgery.”

Dr Sin YongOn hard lumps from mixed fillers and skin boosters

A long, pointed ‘witch’ chin or a wide jaw after filler: overfilling

A chin that juts too far forward, hangs too low or narrows to a point is most often too much filler, frequently added as top-ups on filler that had not gone. A review of facial overfilled syndrome lists the ‘witch’ chin among its signs, alongside ‘chipmunk’ cheeks and the ‘pillow’ face. It attributes the syndrome to excessive filler and poor technique, notes that it is reported mainly in people of East Asian descent, and advises scanning the fat layers before injecting and attention to filler pressure and migration (Lim 2024).

Jawline filler adds width as well as definition. Built up over repeated treatments, or spread beyond where it was placed, it can make the lower face look square, wide or heavy. Not every wide jaw is filler, though. A strong chewing muscle, the shape of the jawbone, fat under the chin and loose skin along the jaw can look the same in photographs, and dissolving changes none of them. The examination and the scan separate them; see square jaw and masseter bulk and V-shape face: chin, jaw, muscle and lift. Where the whole face looks heavy rather than one area, see pillow face.

Where the excess is hyaluronic acid, Dr Sin Yong dissolves it in stages, judging the chin against the nose, lips and jaw at each review rather than all at once. Where it is a collagen stimulator or silicone, he treats it with the Sculpting mode of Time Freeze Laser LCLR®, without an incision.

Chin and jawline filler migration: towards the lower lip, under the chin, along the jaw

Filler does not always stay where it was placed. Chin filler that has moved can spread up towards the lower lip and the crease beneath it, down under the chin, or out to the sides, making the chin look wider or heavier. Jawline filler can spread along the jaw or drop below its edge, blurring the line it was meant to sharpen. Some people notice only that the lower face in photographs no longer looks like theirs.

Migration is a recognised finding on scans. At an ultrasound reference centre, migration and overcorrection were among 52 non-vascular problems seen after hyaluronic acid filler across the face, and scanning with Doppler, which shows blood flow, helped avoid unnecessary treatment (Gonzalez 2024). Silicone migrates too (Harlim 2026), and collagen stimulators can move; neither dissolves.

The scan shows where filler sits now, which is not always where it was injected, so it comes before anything is dissolved or cut. Migrated hyaluronic acid is dissolved where it lies; other materials are treated with the Sculpting mode. Migration elsewhere in the face is covered in filler migration.

Chin and jaw filler lumps: hyaluronic acid, Radiesse, Ellansé, Sculptra or silicone?

A lump in the chin or along the jaw can be product that has clustered or sits too close to the surface, a nodule from a collagen stimulator, the body's reaction around old silicone, or several products layered over the years. What it is made of decides what can be done. A technique paper on chin and jawline augmentation describes using calcium hydroxylapatite, a stiff hyaluronic acid or a hybrid of the two, depending on the goal (Moradi 2019), so in these areas the material cannot be assumed.

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Collagen-stimulator lumps are often stubborn. In 55 complications from collagen stimulators in general (poly-L-lactic acid, calcium hydroxylapatite and polycaprolactone), collected by ultrasound specialists, nodules made up 89% and usually appeared more than a month after treatment. Despite saline, hyaluronidase, diluted medical treatment and energy-based devices, only 5 resolved completely, and hyaluronidase helped only where calcium hydroxylapatite had been mixed with hyaluronic acid (Ianhez 2024).

Material that cannot be dissolved can still be treated without an incision. Dr Sin Yong maps it with ultrasound and treats it with the Sculpting mode of Time Freeze Laser LCLR®.

Silicone chin lumps: what happened after surgery in 35 patients

Liquid silicone injected into the chin cannot be dissolved, and it can form hard lumps and granulomas, the body's walled-off reaction around the silicone, sometimes years after the injection. Patients with silicone chin lumps are often told the only answer is to cut them out. One long-term study of that operation is worth knowing before you agree to it.

In a cohort of 35 patients with granulomas from liquid silicone injected into the chin, treated between 2015 and 2025, every patient had the granulomas cut out through an incision under the chin. Seventeen then had medical treatment injected into the area, and 18 had surgery alone (Harlim 2026). The study reports:

• The operation helped. Chin shape and redness improved, and complications occurred in 2.86%.
• The granulomas came back. They returned in 44.4% of those who had surgery alone, against 5.89% of those who also had the medical treatment.
• The shape did not hold after surgery alone. In the surgery-only group, the shape of the chin worsened again.
• Complete removal is nearly impossible, the authors say. The authors state that complete surgical removal of injected silicone is nearly impossible, because silicone migrates, and that what remains causes a high rate of recurrence (Harlim 2026).

Surgery has a place, and this study shows both sides: the operation improved chin shape and redness, and with added medical treatment the granulomas came back in 5.89%. It also shows the limits: silicone spread through the chin is nearly impossible to cut out completely, and the scar under the chin stays.

Dr Sin Yong maps silicone chin lumps with ultrasound and treats them with the Sculpting mode of Time Freeze Laser LCLR®, without an incision. Hyaluronic acid placed over old silicone is dissolved first, after a skin test, and a red, hot or tender lump is treated medically before anything else. More is in silicone filler lumps.

Ultrasound first: what the scan shows in the chin and jaw

Ultrasound shows where the filler sits, how deep it is and how far it has spread, and what it is likely made of. In the chin and jaw, the same area may hold firm hyaluronic acid, calcium hydroxylapatite, polycaprolactone or old silicone, sometimes layered over each other, and only hyaluronic acid dissolves. The scan also shows the blood vessels running beside the filler, and fluid or an abscess if there is one.

An international consensus of 15 experts from seven specialties calls ultrasound mandatory for managing filler complications, and states that ultrasound guidance is needed for precise injections into a lesion when treating them (Velthuis 2025). In a study of 231 patients with firm lumps after cosmetic filler, not specific to the chin, ultrasound agreed with the tissue diagnosis in 85.7% of the 70 who had a biopsy. The commonest findings were a collection of filler that was not hyaluronic acid (37.2%) and a granuloma around such filler (22.5%). Granulomas around remaining non-hyaluronic acid filler responded better to non-invasive treatment, while granulomas with no filler left, and hyaluronic acid with a granuloma, did better with invasive treatment, which gave greater improvement overall (Wang 2026).

The scan shows what a lump is likely made of; it does not prove it. Lumps under the jaw are a case in point. In a published case, a man had lumps under both sides of the jaw that MRI showed as masses and ultrasound suggested were cysts or lymph nodes; only a fine-needle sample taken under ultrasound showed that they were migrated filler with a foreign-body reaction. The authors note that doctors reading the scans may not recognise filler without an injection history, and that patients may not mention it (Virata 2026). Tell whoever scans you about any filler, however long ago. Where a lump does not look like filler, further tests are arranged. Dr Sin Yong performs the scan himself, and the plan follows what it shows. More on scanning is in ultrasound-guided filler correction.

What Dr Sin Yong does: maps, dissolves, and treats the rest without an incision

1. Maps. Dr Sin Yong scans the chin and both sides of the jaw himself: the likely material, its depth, how far it has spread and the vessels nearby.
2. Treats inflammation or infection first. A red, hot, tender, swollen or draining lump is treated medically before anything else.
3. Dissolves hyaluronic acid. He uses hyaluronidase, an enzyme that acts on hyaluronic acid only. Your allergy history is checked, including any reaction to bee or wasp stings and any earlier hyaluronidase. Before planned dissolving, Dr Sin Yong always does a skin test: a small amount of hyaluronidase is injected just under the skin to check for a reaction. A small first dose goes into the mapped excess, with a review at about 48 hours before any more, because dissolving more than the excess can leave the chin weaker than intended or leave a hollow. Where the chin projects too far and the jaw looks wide, the two are dealt with in steps. Refilling, if wanted at all, waits at least two weeks. Step-by-step detail is in chin and jaw filler dissolving, and the skin test in hyaluronidase allergy and the skin test.
4. Treats what cannot be dissolved, without an incision. Radiesse, Ellansé, Sculptra, the poly-D,L-lactic acid in Juvelook, silicone, polyacrylamide gel, PMMA and fat graft cannot be dissolved, but they can still be treated without an incision. He treats them with the Sculpting mode of Time Freeze Laser LCLR®, his own protocol on a long-pulsed 755 nm and 1064 nm laser platform, directed at the mapped lump. Like any laser, it can cause blistering or a change in skin colour, so settings are chosen for your skin.
5. Reviews. Each area is reassessed, and any further visit is planned from what is seen.

He does not inject more filler to hide a lump or to balance a chin against a jaw. Where the lower face has lost shape, that is considered only after the excess has been dealt with.

Surgery for chin and jaw filler: what it involves, and the nerve along the jaw

Surgery to take filler out of the chin or jaw means an incision, through the skin under the chin, from inside the mouth, or through facelift incisions in front of the ear, and cutting out the filler together with the tissue it has spread into. Filler woven through tissue cannot be separated from it cleanly, so the operation either takes that tissue too or leaves some filler behind.

The nerve along the jaw

The marginal mandibular branch of the facial nerve moves the lower lip. It runs along the jaw, close to where jawline filler sits. In a meta-analysis of 28 studies covering 1,861 half-faces, it usually had one or two branches, at least one branch ran below the lower edge of the jawbone in a pooled 39%, and its origin, branching and connections varied; the authors link this variation to the risk of nerve injury in surgery of the region (Marcuzzo 2020). A review of the facial nerve outside the skull, region by region, including the jawline and the area around the mouth, describes considerable variability in its course and branching, and higher surgical risk where it runs superficially or unpredictably (Sagkriotis 2026).

Injury is not theoretical. In 50 women who had non-absorbable filler drained from the face, followed by a facelift with fat grafting, 4 had neuropraxia of the facial nerve's mandibular branch, meaning the nerve stopped working for a time, and 5 had thick, raised scars; the authors describe the surgery as successful in all (Gadallah 2023). Weakness of this branch shows as a lower lip that does not move down on one side, most visible when you smile or talk.

Under the chin, inside the mouth, or through a facelift incision

• Under the chin. In the silicone series, granulomas were cut out through an incision beneath the chin; they came back in 44.4% after surgery alone, and the authors attribute the high recurrence to silicone left behind (Harlim 2026).
• Inside the mouth. The chin can be reached through the lining inside the lower lip. There is no scar on the skin, but tissue is still cut and removed, and the nerves that give the lower lip and chin feeling lie in this area.
• Through a facelift incision. The jaw is reached from the side, through incisions in front of the ear. In the series of 50, temporary weakness of the mandibular branch and thick, raised scars followed (Gadallah 2023).

Surgery has a place. In the silicone series, the operation improved chin shape and redness (Harlim 2026). Some lumps do need a procedure: an abscess may need draining, and a lump that does not look like filler on the scan may need a tissue sample. The point is the order: scan first, decide after. An operation can still be done later if it is ever needed; it cannot be undone. More is in filler removal surgery, and if you have already been offered an operation, Dr Sin Yong can scan the area and give you a second opinion before you decide.

Swelling months later, infection or a blocked vessel: when to act

Swelling months later. Chin or jaw swelling that appears months after filler can be a delayed reaction to the filler or an infection. An expert consensus on hyaluronic acid filler says late reactions typically appear three to four months after the injection, lists the structure of the filler, infection and the body's immune response as proposed causes, and names recent dental treatment among the risk factors. It recommends hyaluronidase for reactions that are neither inflamed nor infected, says waiting or medical treatment may be preferred for inflamed ones, and advises drainage, a culture and antibiotics, not hyaluronidase first, for an infection (Baranska-Rybak 2024). In a published case, a woman had an abscess under the chin that kept coming back after hyaluronic acid chin filler; the authors discuss bacterial contamination and an immune reaction as possible causes, and it was managed with hyaluronidase guided by ultrasound, an approach they describe as predictable (Nicola 2024). More is in swelling months after filler.

A blocked blood vessel. The chin and lower lip are supplied by small arteries, including the mental artery and its branches, that run close to where chin filler is placed. Filler that enters or presses on one of them can cut off the blood supply to the skin of the chin or lower lip. The warning signs are pain that is severe or getting worse, and skin that turns pale, then dusky, purple or mottled. No vascular complications were reported in the systematic review of 917 people (Ou 2023), but when it happens it is an emergency. If the filler is hyaluronic acid, hyaluronidase is given at once, without waiting for a skin test.

Urgent: a change in vision or eye pain after filler: call 995 now. Skin that turns pale, dusky or mottled, or pain that is getting worse, needs urgent assessment by the doctor who injected you, or at A&E, now. See the warning signs of a blocked blood vessel after filler.

Skin that is dying after a blocked blood vessel (necrosis) is an emergency. It needs urgent, more intensive care than a lump does, starting now.

• A lump or swelling that is red, hot, tender or draining may be infected or actively inflamed. It is treated medically first, before any dissolving, any device and any talk of surgery. Fever, or feeling unwell with a swollen lump, needs review the same day.
• Difficulty breathing, a tight throat, swelling of the tongue or throat, or swelling that spreads quickly across the face, after any injection, including hyaluronidase, can be a serious allergic reaction: call 995 now. Itch, hives or swelling that spreads beyond the treated area: contact the clinic that injected you the same day.

Tried other treatments and almost given up?

Many patients who come to see Dr Sin Yong about chin and jawline filler problems tell him they have tried almost everything else and had given up hope. Having tried other treatments does not mean nothing more can be done: what is done next depends on what the scan shows.

That history is useful. Knowing what was injected, when, and what has already been tried often explains why a problem has stayed: hyaluronidase acts only on hyaluronic acid and only where it reaches, some fillers are not hyaluronic acid at all, and swelling or fluid can look like filler. Ultrasound helps show which of these applies, and the plan starts from there. For material that cannot be dissolved, Dr Sin Yong uses the Sculpting mode of Time Freeze Laser LCLR® for nodules large and small, without an incision. How each person responds varies.

If you have been told nothing more can be done, it is still worth having the area scanned: ultrasound helps show what is there, and the plan is made from that. Bring any records of past treatments, product names and dates if you have them. More on this is in when filler dissolving has not worked.

How Dr Sin Yong treats chin and jawline filler gone wrong

Dr Sin Yong examines the lower face from the front, the side and below, at rest and as you talk and smile, because the chin, the jaw and the lips change how each other look. He performs the ultrasound scan, any dissolving and every Sculpting mode treatment himself on Orchard Road. He developed the Time Freeze Laser LCLR® protocol himself and has been invited to share his clinical expertise in Seoul, Dubai, Bangkok and São Paulo, including as a Global Key Opinion Leader.

The excess is dealt with first, the area is reviewed once it has settled, and only then is anything else discussed, including leaving it alone. You do not need to have been treated here, and having no records of what was injected is fine. More on the laser is in the Sculpting mode of Time Freeze Laser LCLR®, and on treatments done abroad in correction of filler done overseas.