How to get rid of fat pockets and dimples on my chin?

Question

Since very young I’ve had these fat pockets & dimples/marionette marks under my lower lip/chin area. I’ve had botox 4 times before to try to correct them but they still show up. I got botox again 2 weeks ago & the “dimples” are even more noticeable now when I speak or close my mouth. I also have these weird fat pockets under my lip that don’t help the situation at all. What should my next move be? What do I need to do to get this fixed once and for all?

Anna Chacon, MD, FAAD · Answer

Addressing fat pockets and dimples in the chin area can be challenging, especially if previous treatments like Botox have not provided the desired results. Here are some steps and options to consider as your next move:

1. **Consult with a Board-Certified Dermatologist or Plastic Surgeon:**
   - It’s essential to have a thorough evaluation by a specialist who can assess your specific situation and recommend personalized treatment options. They can determine whether the issue is primarily due to muscle activity, fat deposits, or skin laxity.

2. **Alternative Injectable Treatments:**
   - **Fillers:** Dermal fillers can help smooth out dimples and marionette lines by adding volume to the area, potentially providing a more even appearance.
   - **Kybella:** This injectable treatment is designed to dissolve submental fat (under the chin). It might help reduce fat pockets if they are contributing to your concerns.

3. **Non-Invasive Procedures:**
   - **Ultrasound or Radiofrequency Treatments:** These treatments, such as Ultherapy, use energy to stimulate collagen production and can help tighten the skin and reduce the appearance of dimples and fat pockets.
   - **CoolSculpting:** This non-invasive procedure targets and freezes fat cells, which are then naturally eliminated by the body. It might be an option if fat pockets are a significant concern.

4. **Surgical Options:**
   - **Liposuction:** For more substantial fat deposits, a plastic surgeon might recommend liposuction to remove excess fat and contour the chin area.
   - **Chin or Neck Lift:** If skin laxity is a major factor, a surgical lift can help tighten the skin and underlying tissues, providing a smoother appearance.

5. **Skin Care and Lifestyle:**
   - **Topical Treatments:** Retinoids and other skin-firming products can improve skin texture over time.
   - **Healthy Lifestyle:** Maintaining a healthy diet and regular exercise can help manage overall body fat, which might positively influence the appearance of fat pockets in the chin area.

6. **Review Botox Technique:**
   - Sometimes, the technique or placement of Botox injections can affect results. Discuss with your practitioner whether adjusting the injection sites or dosage might improve the outcome.

7. **Combination Treatments:**
   - Often, a combination of treatments can provide the best results. For example, using fillers in conjunction with skin-tightening procedures might address both volume loss and skin laxity.

Given your history and concerns, it’s crucial to work closely with a qualified professional who can guide you through the available options and develop a comprehensive treatment plan tailored to your needs.

Sheryl D. Clark, MD, FAAD · Answer

Hello jesscarlet:

You are a great candidate for chin fillers. Your chin is relatively small and recessed, which results in all the features you are describing.

A robust filler with a high G’ would be best, and you will want to find an advanced injector with many years of experience and an In-depth knowledge of the anatomy of the chin. A cannula would be best in this area to avoid injecting a blood vessel and to minimize trauma and bruising. I think you would be happy with the results.

All the best from NYC,
Sheryl Clark MD FAAD

How to get rid of fat pockets and dimples on my chin?

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How to get rid of fat pockets and dimples on my chin?

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