Bulge under lower lip - what options do I have? (Photos)

Question

think I have mentalis overactivity causing a bulge under my lower lip. I want a conservative Botox treatment there first, and only minimal filler in the labiomental fold if needed.” That muscle is subtly pushing the area under your lip forward → which makes the lower lip look even more projected

Nelson Lee Novick, MD · Answer

At least from the photos provided, it would appear that the bulging below the lower lip that disturbs you is being emphasized by a deep mental crease (the chin crease that runs horizontally below the lower lip and above the chin). To create greater harmony and proportionality in profile view and to diminish the appearance of the bulge below the lower lip, you might wish to consider the use of robust HA volumizing filler to increase slightly chin projection to bring it more in line with the projections of the nose and the lips, and the use of a robust HA lifting filler for the mental crease (which when elevated and smoothed would diminish the appearance of the bulge below the lower lip). You would be wise to make sure to consult with a board certified cosmetic dermatologist filler injector expert. 
Prior to actual treatment, a test of treatment outcomes can be performed using simple saline or diluted anesthetic into the chin and mental crease to obtain a better real-world assessment of outcome prior to actual treatment. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing the details and photos. From what you’re describing, it does sound like the mentalis muscle may be contributing to the subtle bulge under your lower lip. When this muscle is overactive, it can push the tissue forward and make the lower lip appear more projected, as you’ve noticed.

A conservative Botox treatment to the mentalis is a common and effective first step. By gently relaxing this muscle, we can reduce the bulge and help smooth the area without affecting your natural lip movement or expression.

For the labiomental fold, sometimes minimal filler is helpful to blend the transition and create a smoother contour, but it’s often best to see the result of the Botox first—this can sometimes reduce or even eliminate the need for any filler.

Overall, your plan of starting conservatively with Botox and reassessing for minimal filler is exactly how I would approach this situation. The goal is a natural-looking improvement without overcorrecting or creating unwanted fullness.

With careful placement and dosing, you can expect a subtle, refined result that addresses the bulge while keeping your lower lip movement natural.

Bulge under lower lip - what options do I have? (Photos)

Answers (2)

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