How to get rid of this crease that forms on my chin? (Photo)

Question

When I smile i get this crease that forms on my chin. It’s not a big deal but it bothers me. I’ve already tried 4 units of botox in my chin

Nelson Lee Novick, MD · Answer

Since the crease appears with smiling, I.e. movement, Botox would seem to be quite appropriate. You're lack of response to the prior Botox treatment might be related to the usage of an insufficient dosage and/or inappropriate placement of the injections. In either case retreatment would be in order. 
Additionally, the use of a small amount of a low viscosity, malleable, cohesive HA filler injected properly right below the crease can provide the necessary structural support to diminish or eliminate the crease when smiling. You would be wise to make sure to consult an experienced, board certified cosmetic dermatologist injection expert and best of luck

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photo—this is a very common concern, and I understand why it catches your eye even if it seems subtle to others.

What you’re noticing is a dynamic chin crease, meaning it appears with movement (like smiling) rather than being etched into the skin at rest. This typically comes from a combination of strong mentalis muscle activity, chin shape, and how the skin folds with expression.

You’ve already tried 4 units of Botox, which tells me a couple of important things:

The issue is likely partially muscular, but not entirely

Either the dose was too conservative, or

Muscle relaxation alone isn’t enough to fully smooth the crease

Why Botox alone may not be enough

Botox can help relax the mentalis muscle, but when a crease is caused by skin folding over underlying anatomy, Botox by itself may only soften—not eliminate—it. In some people, relaxing the muscle too much can even make the fold look more noticeable, so dosing has to be very precise.

Other approaches that can help

Depending on your anatomy and how the crease behaves at rest vs movement, options that are sometimes used include:

Careful adjustment of Botox dosing or placement (not necessarily more units, but different distribution)

Very superficial hyaluronic acid filler to support the skin so it doesn’t collapse into a fold when you smile

Skin-quality treatments (like collagen-stimulating approaches) if the skin itself is thin or crepey

The key is that this area requires a balanced approach—too much muscle relaxation or too much filler can make the chin look unnatural, which is never the goal.

Setting realistic expectations

Because this crease is expression-related, it’s unlikely to disappear completely without affecting natural movement. The goal is usually to soften it enough that it no longer draws your attention, while still allowing your smile to look like you.

From what I see, this is not a flaw—it’s a normal movement pattern that can be refined thoughtfully. When treated conservatively and strategically, the chin can look smoother without looking stiff or overdone.

How to get rid of this crease that forms on my chin? (Photo)

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