Large mentalis muscle (witch chin) reduction with Botox?

"Witch's chin" usually refers to a deformity in which the soft tissue (skin, fat, and/or muscle) of the tip of the chin is both protruding and hanging downward. This can be corrected with relatively minor surgery in an office setting using numbing medicine (local anesthesia) through a short incision just under the chin, where the scar won't be very visible. On the other hand, Botox works as a muscle relaxer and when injected into the muscles near the center of the chin will relax those muscles and decrease any of the crinkling or dimpling of the skin that you might see over the chin when you have an expression. However, Botox does not actually reduce the muscle or size of the chin. You should see an experienced, board certified plastic surgeon to discuss your goals and let the doctor analyze your condition and then form a treatment plan best for you.

I have been using Botox for aesthetic purposes since 1991 and have been treating dimpled chins for at least fifteen years. If the dimpling or pebbling is related to hyperactivity of the chin muscle (mentalis muscle), then the instillation of one to three tiny droplets in specific locations of neuromodulator using any of the three currently available (Botox, Dysport, Xeomin) can suppress this activity and lead to smoothing of the chin. If a few individual depressions remain following this treatment, they can be smoothed by injecting a tiny amount of filler (my favorite for this being Restylane L due to its better lifting capacity and more limited ability to attract tissue fluid to itself). The result of these treatments: a smoother chin (without contributing to further chin projection). It should be clear that it is important to seek consultation and treatment by a board certified aesthetic physician with extensive experience in nonsurgical chin enhancement. 

The orange peel chin is due to overactivity of the mentalis muscle. Botox injected into this muscle can reduce the bumpy appearance but will not diminish a protruding chin to any great extent.