What is the best way to get rid of my chin dimple? (photo)

Chin dimples can sometimes give a masculine appearance to the jaw.  A deep chin dimple can result from the anatomy of the mandible, or a deep recess between the bellies of the mentalis muscle.  A deep dimple is difficult to totally fill.  Patients should know that a correction will be made, but that the dimple will not totally disappear.   To soften the the chin dimple and rejuvenate the chin, I have used injectable fat or hyaluronic acid (HA) fillers (juvederm, perlane, restylane, or belotero).  HA fillers are all temporary solutions, as all get absorbed by the body.  Fat also gets absorbed by the body, but some fat should survive.  Serial injections of fat can have some long standing, potentially permanent results.  I recommend that patients start with this technique first.To fill a very deep depression, a small amount of skin and fat can be harvested from a well hidden incision.  This dermal fat graft can be placed through a small intra-oral or sub mental (below the chin) incision.   Neurotoxin (Botox, Dysport or Xeomin) injection into the depressor anguli oris (DOA) muscle can help with some of the dynamic wrinkles that occur on the chin when the patient depresses the lip.  I have not found these neurotoxins to be useful for chin dimples.I have seen a lot of problems with silicone injections, and do not recommend them anywhere for cosmetic reasons.  The silicone is spread throughout the soft tissue, and can become infected or inflamed.  Patients can have recurrent granulomas and present with firm, red, painful inflamed areas where the silicone was injected and dispersed.  In many cases, this silicone has to be repeatedly cut out as it becomes re-inflamed.  This leaves terrible scarring and can be extremely deforming.  I do not know of any Board Certified Plastic Surgeons who presently perform silicone injections to the face, buttocks, or the breast.Make sure that you see a board certified plastic surgeon. 

A physical exam will help with this, but muscle plication and fat grafting is usually a good treatment combination if this is superficial in nature.  Kenneth Hughes, MDLos Angeles, CA