Would Botox help fix my chin ptosis or surgery?

Question

I feel like my chin is what causes the problem with my side profile and why my side profile is so ugly. I think I have chin ptosis/ witch chin but I don’t know how to fix it. If I smile with my teeth, you can see it hangs but it I smile close lipped it doesn’t. It’s when I talk to say certain words I can see my chin move and I do have the dimpling anytime I smile with teeth. I am super nervous about chin Botox because 90% of the reviews I see online is that it went wrong. Plz help!

Eric M. Joseph, MD · Answer

Since the droopiness of your chin only happens with a forced smile, and since you also say that you have dimpling in your chin, I believe that considering Botox would be a reasonable first step. If you don't like the way it looks, the results were off completely. If you like the way it looks, this would be a relatively easy fix. I wish you well moving forward, and I hope this is helpful. Sincerely, Dr. Joseph

Anna Chacon, MD, FAAD · Answer

Chin ptosis, often referred to as "witch's chin," can indeed affect the aesthetics of the side profile and overall facial appearance. It's understandable that this might be causing you concern. There are a few treatment options available, and each has its own set of benefits and potential risks. Here is a brief overview of the potential treatments:

### Non-Surgical Options

#### Botox (Botulinum Toxin)
- **Mechanism**: Botox works by temporarily paralyzing the muscles that contribute to the downward pull of the chin.
- **Pros**: 
  - Minimally invasive.
  - Quick procedure with minimal downtime.
  - Results are temporary, which can be a pro if you are unsure about permanent changes.
- **Cons**: 
  - Results typically last 3-6 months, requiring repeat treatments.
  - Risk of complications such as asymmetry, difficulty with certain facial movements, or an "unnatural" appearance if not done correctly.
  - Effectiveness varies, and some people may not achieve the desired result.

#### Dermal Fillers
- **Mechanism**: Fillers can be used to add volume and structure to the chin area, potentially improving the appearance of ptosis.
- **Pros**: 
  - Minimally invasive.
  - Immediate results with minimal downtime.
  - Temporary and reversible.
- **Cons**: 
  - Results are not permanent, typically lasting 6-18 months.
  - Risk of complications such as infection, asymmetry, or allergic reactions.

### Surgical Options

#### Chin Augmentation (Genioplasty)
- **Mechanism**: Involves altering the bone structure or adding an implant to reshape the chin.
- **Pros**: 
  - Permanent results.
  - Can significantly improve the side profile and overall facial balance.
  - Customizable to address specific concerns.
- **Cons**: 
  - Invasive procedure with longer recovery time.
  - Risks associated with surgery, such as infection, nerve damage, or dissatisfaction with the results.
  - Higher cost compared to non-surgical options.

#### Soft Tissue Procedures
- **Mechanism**: Procedures such as submental liposuction or a chin lift can remove excess tissue or tighten the area.
- **Pros**: 
  - Can provide a more defined and youthful appearance.
  - Permanent results.
- **Cons**: 
  - Invasive with associated surgical risks.
  - Recovery time required.

### Considerations and Recommendations

1. **Consultation with a Specialist**: The first and most important step is to consult with a board-certified plastic surgeon or dermatologist who specializes in facial aesthetics. They can provide a thorough assessment and recommend the most appropriate treatment based on your specific anatomy and aesthetic goals.

2. **Understanding Risks and Benefits**: Make sure you understand the potential risks and benefits of each option. Ask about the surgeon's experience with chin ptosis and request to see before-and-after photos of previous patients.

3. **Realistic Expectations**: Ensure you have realistic expectations about the outcomes. Non-surgical treatments offer temporary improvements, while surgical options provide more permanent changes.

4. **Second Opinion**: If you are unsure, consider seeking a second opinion to explore all available options and make an informed decision.

Given your concerns about Botox and the mixed reviews you've read, it might be worth exploring both non-surgical and surgical options with a qualified professional to determine the best course of action for your specific situation.

Michael A. Persky, MD · Answer

Hi R,
Unfortunately Botox is not the answer to your chin.  It requires a surgical procedure addressing the muscle and in some cases the bone.  Make sure to consult with an expert facial plastic or general plastic surgeon who specializes in this not so common surgical correction.  Good luck and be well.
Michael Persky, MD
Encino, CA

Jacquelline Leva, DO · Answer

Botox will make your chin droop more not better! Consider speaking to a plastic surgeon to see if you are a good candidate for an implant.

Camille Cash, MD · Answer

From the provided photos it appears the animation created during smiling is normal.  Botox is helpful for those with an orange peel or dimpled chin.  Visit with an expert injector to further discuss your concerns and learn more.

Leonard Grossman, MD · Answer

Why is it that you’re concerned with the movement of your chin while you smile? There is a multitude of muscles that are involved during the smiling process. This by any means does not mean that we have to do something to these muscles. There’s absolutely nothing wrong with your smile. Only if you wish to create a new problem, would I do anything such as Botox or surgery. Instead of focusing on a minuscule something that you don’t like in your smile, I would focus on being a good person, doing a lot of reading and being kind. You will find that you’re much more beautiful when you do all these things. I hope this helps and good luck from Leonard Grossman, MD, organic Plastic Surgery.

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