I need suggestions on how to make my chin smooth(er) when I smile or move my my face. (Photo)

Question

I have extra tissue/fat on the front of my chin. It looks ok when i'm not smiling or talking, but when I smile the tissue distorts in a weird way and makes dimples/lines. It also makes my chin uneven. I'm concerned about removing the excess tissue because my jaw is very small and I feel like I would look like I had a weak chin without it. I would like my chin to be smooth or smoother when I smile. Are there fillers or botox or something that would help? SLIGHT lipo? What are the options?

Nima Shemirani, MD · Answer

Dear Chinstuff,Thank you for your question and photos. Based on your photos, you would benefit from Botox injections. The lines that you describe on your chin are caused by overactive muscles that can be injected with Botox to help smoothen out your chin. Please see a board-certified plastic surgeon for a consult to better address your concerns. Best regards,Nima Shemirani

John L. Burns Jr., MD · Answer

I would suggest trying a small dose of botox to relax the mentalis muscle which is straining during animation.

Ronald Friedman, MD · Answer

The "smile lines" on your chin are due to overactive muscles that may be best controlled by Botox injections.  Filler injections will not be successful.  Why not?1. Dynamic lines are wrinkles which occur with talking, smiling, frowning, or other facial animation.  They are not present at rest and are due to muscle action on the overlying skin.  Botox relaxes the muscles, reducing the dynamic lines.2. Static lines are wrinkles which are present at all times, even when you are standing still doing nothing. These are best treated with facial fillers (Restylane, Juvederm, etc.).Since you are experiencing dynamic lines (and not static lines), Botox is your best treatment.

Mats Hagstrom, MD (license on probation) · Answer

I think your best option is to try Botox.
There are a few muscles that could be contributing to the skin Lines your face creates while smiling.
These include the mentalis muscle or the depressor anguli Oris muscle.
It may take some experimenting and you should definitely look for a boat that's provider Wesson integral understanding of facial anatomy.
I would not recommend any surgical intervention.
Using fillers for dynamic skin folds is sometimes not all that successful.
What this means is adding fillers to lines that on the form when you contract muscles may have an undesirable affect when those muscles are not contracted or your face is in a neutral relaxed state.
Best,
Mats Hagstrom M.D.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  From the photos, your chin is very weak and there appears to be both a lack of adequate mentalis muscle volume along with specific areas of muscle hypertrophy creating the dimples and grooves when smiling.  There is some excess skin but very little if any fat...both can be removed at at the same time that the chin implant is placed. A step wise approach to the treatment makes the most sense to me.  First augment the weak chin with a properly placed silastic chin implant as described below.  Then at about 3 months post-op, if the dimples and grooves persist, use Botox or a similar neurotoxin precisely placed to create spot weakening of the mentalis muscle. When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  
 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.  
Hope this helps.

Jon A. Perlman, MD (retired) · Answer

My suggestion is that you find an expert botulinum injector and receive conservative doses to your mentalis muscle (this usually reverses dimpling of the chin) and to the DAO muscle to see the improvement that you can achieve.  I think you will find these techniques to be helpful and worth testing.  Best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

Bijoy Methil, MCh, MS, DNB (in memoriam) · Answer

Thanks for your question. This can be easily resolved with botox and some filler. Please visit a board certified plastic surgeon or dermatologist who is well versed with facial aesthetics. The accurate placement and dosage of botox is critical. After the effect of botox is established, a filler will help achieve better contour and definition. You have a deep labiodental crease and a under projected chin. Again, Position/Product/Volume are all critical for a great result. All the best.

I need suggestions on how to make my chin smooth(er) when I smile or move my my face. (Photo)

Answers (7)

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