Best treatment for pointy chin/witches chin?

Thank you for sharing your concerns and providing a photo for evaluation. Based on your description, it sounds like you are experiencing what is commonly referred to as a "witch's chin," which can be characterized by a downward projection of the chin, especially noticeable when smiling.

Here are a few potential treatment options to consider:

Chin Reduction Surgery (Mentoplasty): This procedure can specifically target the excess soft tissue and muscle at the end of your chin, reshaping it to create a more balanced profile without altering the front view of your face. This surgery can effectively address the downward projection and improve your side profile.

Botox Injections: Although you mentioned previous experience with Botox without significant results, it might still be worth discussing with your practitioner. Properly administered Botox can help relax the mentalis muscle, which is responsible for the downward pull of the chin when smiling. This might require a different technique or dosage than previously tried.

Dermal Fillers: Strategic use of dermal fillers can help to subtly reshape the chin area by adding volume in specific spots, potentially reducing the appearance of downward projection. However, this approach is more about contouring and may not address significant soft tissue issues.

Submental Liposuction: If there is excess fat contributing to the appearance of a drooping chin, submental liposuction can help remove this fat, providing a more defined and lifted appearance.

Given your desire to maintain the overall appearance of your face and only modify the chin area, it is crucial to consult with a board-certified plastic surgeon or a facial plastic surgeon. They can provide a thorough evaluation and recommend a treatment plan tailored to your specific needs and aesthetic goals.

Best regards,

You have a pleasing jawline and profile appearance when you are not smiling. Your platysma muscle may be hyperactive when you smile, and depending on your examination, targeted Botox treatments may be considered if there is muscular activity pulling the soft tissue of your chin downward when you smile. I hope this is helpful. Sincerely, Dr. Joseph

This a difficult problem because the worst appearance occurs when you smile or animate the muscles. It doesn't appear that the bony chin is the problem. The resting appearance of your chin can be improved with a chin tuck, platysmaplasty, and a fat pedicled transfer to reduce the deep submental crease. The dynamic changes are best treated with botox. I sometimes use deoxycholic acid to shrink the fibrofatty tissue of the chin.