What do you recommend to fix my chin ptosis and smile? (Photo)

Question

Looking for suggestions to fix my smile? I have chin ptosis and my teeth do not show when I smile. I've already had braces to try and fix my bite.

Michael P. Morrissette, DDS, FACS · Answer

The photos are limited but I don't think that you have true chin ptosis. What I do see is a small chin button and wide jawline which accentuates the pointedness of the chin. The bony chin can be shaved, sometimes a lateral augmentation with a small silicone chin implant that does not increase projection. Reducing the soft tissue chin pad is not easy but it can be reduced with surgery and Kybella treatments.

John L. Burns Jr., MD · Answer

Looking at your photos, you appear to have a rather prominent chin and a chin prosthesis would only accentuate what you do not like about your profile, my suggestion would be a small chin reduction.  Consultation with an orthodontist is appropriate as well

Jeffrey H. Spiegel, MD · Answer

Chin ptosis is something we address frequently at my practice. If it is only when you smile you can consider botulinum (e.g. botox) to the area.  If it also occurs when you are not smiling we can reshape the chin pad through a small incision underneath the chin to reduce the excess.  If there is excess or misshapen bone, that can also be addressed.

Zoran Potparic, MD · Answer

It is very difficult to give you a meaningful comment. In person or teleconference consultation with a board certified plastic surgeon with expertise in chin augmentation would help to help to properly evaluate your condition. Good luck.

J. Renee Booth, MD · Answer

It appears that the upper teeth show more than your lower teeth when you smile. If you want to improve the show of the lower teeth, then I recommend that you see an Oral Maxillofacial Surgeon experienced in surgeries to correct the bones and improve bite when braces cannot. You may also think about seeing a cosmetic orthodontist, such as nationally renowned David Sarver DMD. The projection of the mandible appears appropriate; however it is still difficult to see the lower teeth. This means it is unlikely that you need the mandible moved forward. This scenario could be associated with inadequate height of the mandible, slanting of the anterior face of the mandible backwards, lower tooth retrusion, or possibly some combination of these.If you want to increase the show of the upper red lip, then you can try a "lip flip" which is neurotoxin (such as Botox) to relax the upper half of the mouth muscle (called the orbicularis oris). In some people, the unrelaxed muscle pulls the upper red lip to face downward when it pulls taut during smiling. Relaxing the muscle allows the upper red lip to continue facing forward when smiling instead of facing downward. Botox requires treatment every 3-4 months to maintain the effect. If you want more upper tooth show and permanent improved upper red lip show, then a lip lift surgery is a reasonable option. For the prominent chin, the options are limited. Reasonable options include: 1. Botox in the chin muscle called the mentalis to help thin the muscle and 2. radiofrequency microneedling (such as Profound RF) to tighten/minimize the soft tissue of the chin.

What do you recommend to fix my chin ptosis and smile? (Photo)

Answers (5)

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