Noticeable amount of soft tissue on the tip of my chin that I can pinch between my fingers - how can I fix this? (Photos)

Question

Hi, I’m 1.5 years post chin liposuction, and unfortunately it didn’t improve the issue that bothered me the most. In almost every photo someone takes of me, I have a very pronounced contour/indentation around my chin, especially when I smile. It makes me look like I weigh 20 kg more than I actually do, even though I’m quite slim. I have a noticeable amount of soft tissue on the tip of my chin that I can pinch between my fingers, and it protrudes more when I smile. I’m not sure whether this is caused by an overactive mentalis muscle, excess or deficient soft tissue, or something else. I would really appreciate it if a specialist could share their opinion or suggest what might be causing this and what treatment options could help. Thank you!

Anna Chacon, MD, FAAD · Answer

Thank you for providing such a detailed description and the photos. I can understand why this is frustrating, especially after going through chin liposuction and still seeing the contour that bothered you most.

Based on your description and the appearance in the photos, I would be cautious about assuming that the tissue you can pinch is simply leftover fat. The fact that it becomes more prominent when you smile is a very important clue.

What I suspect is happening

The chin area is influenced by several structures:

Skin
Subcutaneous soft tissue
The mentalis muscle
The underlying chin bone (mentum)

When someone says:

“I can pinch a noticeable amount of tissue on the tip of my chin,” and
“It protrudes more when I smile,”

I often think about mentalis muscle overactivity combined with soft-tissue bunching rather than persistent fat alone.

Why liposuction may not have helped

Chin liposuction primarily removes fat beneath the chin and along the upper neck/submental area. It is generally not very effective for reshaping the soft tissue directly over the front of the chin, especially if the issue is caused by:

A strong mentalis muscle
Skin and soft tissue redundancy
A deep labiomental fold (the crease between the lower lip and chin)
Scar tethering or contour irregularity after surgery

That is why a person can be quite slim, have a successful submental liposuction result, and still notice a rounded or bulging chin pad in photographs.

The mentalis muscle is a strong possibility

The mentalis is the small muscle in the center of the chin that helps elevate the lower lip and wrinkle the chin skin. When it is overactive, it can create:

A pebbled or dimpled chin
A bulging soft-tissue pad
A deeper indentation above the chin
More fullness when smiling, speaking, or closing the lips tightly

From your photos, I do see features that make mentalis hyperactivity a reasonable consideration.

What treatments are commonly used?
1. Mentalis Botox

This is often the least invasive and most informative first step. A small amount of Botox can relax the muscle and reduce the tendency for the chin tissue to bunch forward when smiling or speaking. If the protrusion is primarily muscular, patients often notice a smoother, flatter chin contour within 1–2 weeks.

2. Filler to support the indentation

If there is a noticeable crease or hollow just above the bulging area, carefully placed filler can sometimes smooth the transition and make the chin appear less prominent, even without removing tissue.

3. Surgical revision (less commonly needed)

This would only be considered if there is:

Significant soft-tissue excess
Scar-related contour deformity
Persistent asymmetry
A structural problem with the chin support itself
One useful self-test

Stand in front of a mirror and compare your chin:

Completely relaxed
Smiling naturally
Tightening the lower lip or pushing it upward

If the bulge appears mainly during smiling or lower-lip movement, that strongly supports a muscular component. If it is equally prominent at rest, then soft tissue, scar tissue, or underlying chin shape becomes more likely.

The encouraging part is that your problem does not sound hopeless, and it does not necessarily mean the liposuction “failed.” In many patients with a similar complaint, the most effective treatment ends up being mentalis Botox, sometimes combined with subtle contour support, rather than additional liposuction.

The fact that you are 1.5 years post-op is actually helpful, because most postoperative swelling should be resolved by now, so what you are seeing is likely close to the true long-term contour, which makes further evaluation and targeted treatment much more reliable.

Noticeable amount of soft tissue on the tip of my chin that I can pinch between my fingers - how can I fix this? (Photos)

Answers (1)

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