26 F. Do I need surgery or are there nonsurgical options to fix dynamic chin ptosis? (Photos)

Thank you for your question and for providing photos. Dynamic chin ptosis is typically caused by repetitive muscle movements, such as smiling. Botox can effectively prevent the associated nerve from stimulating this muscle, reducing the strength of the muscle contractions.
It is possible that this treatment option can reduce the protrusion of your chin when smiling or animating, with results being maintained with regular Botox treatments every 3-4 months. I recommend scheduling an in-person consultation with an experienced, board-certified injector who can determine which treatment option may provide you with the most favorable outcome.

It's difficult to say without the benefit of a formal evaluation. This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Some patients have shins that are slightly more prominent than others. This can be a combination of bony as well as muscle mass. Botox can help soften the animation that happens secondary to the muscle but is unable to help with the bony aspect. A trial of Botox is safe in most patients to see if any impact is seen.

Dynamic chin ptosis can be improved with neurotoxins like Botox. There is not a surgical procedure that that can treat these dynamic changes. A submental reduction will only reduce the size of the chin pad.

It would be very difficult to claim that you have long, prominent chin without full face photos. In person consultation with a board certified plastic surgeon, familiar with this procedure, is the only way to decide whether chin reduction is realy an option for you. Good luck.

Hi Ex,

Botox in the mentalis muscle (chin) projects the chin. Your anatomy requires reduction of your chin. You should consult with an experienced facial or general plastic surgeon for chin reduction surgery. Good luck and be well.

Michael Persky, MD
Encino, CA

Dear Exquisite993197,
Thanks for sharing your photos. You will need a hands-on evaluation to determine what tissues are causing your protruding chin; skin, fat, muscle or bone. You require a full examination and a discussion of the benefits and limitations of facial balance and harmony and chin function to identify what is best for you. All the best!

Thank you for your question about chin movement and how it affects the overlying skin. I would not recommend any surgery. Often people merely think about relaxers such as Dysport, Botox, Juveau and Xeomin as simply helping to flatten out lines or wrinkles. I like to think of relaxers as part of my palette of sculpting tools. In some ways they are a bit like an eraser. Wherever muscles are more active than we want, we can place relaxer in varying dosages and depths to achieve a particular sculpted effect. For example, people who grind and clench their teeth often have thickened masseter muscles towards the back of their jaw in front of the ears. As seen from the front such strength and bulk of the masseter muscles serves to widen and masculinize the face. We can slim the face in a well thought-out crafted manner in order to change the function (e.g. reduced grinding) and appearance (slimming, feminizing). Similarly, relaxers can be used to treat the chin complex of muscles which will bring about a change in how the skin moves and sits. There are a good number of muscles in the chin, such as the mentalis, depressor labii inferioris, and DAO-depressor anguli oris. Treatment of muscles is not an all or none just inject it kind of a thing but rather it is a very customized. For example some muscles such as the labii inferioris are likely going to be specifically avoided, which in itself a form of sculpting treatment. Keep in mind that results from relaxation are seen over weeks and months and may continue to improve for a very long time providing the treatments are kept up. Treatments may want to be repeated every 3-4 months. Good luck.

Chin ptosis, otherwise known as witch's chin can often be corrected with either filler, botulinum or a combination of both treatments. It's all about evaluating the mentalis and DAO muscle movement. In your case it looks as if you have hyperactive DAO muscle which can be helped with careful placement of botulinum.