Can by chin be fixed with Botox or will I need a reduction? (Photos)

Question

I have been getting botox in my chin for a year or two now, sbout 6 units every couple months. I also started get DAO treated. can this issue be treated with just botox or will I have to get a chin reduction?

Katherine Vandenberg, MD · Answer

Hello, From the pictures you have provided above, it appears that you have what we call dynamic chin ptosis. In other words, when you smile, the soft tissue of your chin is pulled downward. The question is, what causes this? If you have never had any surgery or procedures on your chin, then we assume this is a natural anatomic variant in which the depressor muscles of your lip (depressor anguli oris, depressor labial inferioris and platysma) over power the muscles that elevate your lip (mentalis). It has also been observed in people with more prominent horizontal (risorius) smiles rather than smiles that elevate (zygmaticus major). The more powerful risorius muscle dominates the lifting zygomatic muscles, effacing the soft tissue against the bone and causing the chin pad to move inferiorly. Correction includes botulinum toxin injections, which it sounds like you are doing appropriately. I think it is possible for this to improve with continued use of botulinum toxin. However, a chin reduction in which the excess hanging soft tissue is excised is an option.

Michael P. Morrissette, DDS, FACS · Answer

The dynamics of muscle changes when smiling are more difficult to fix. The profile photo, when your chin is at rest, shows a deep mentolabial fold. This indicates a short chin in the vertical dimension. Your chin projection is good, but I would recommend a lengthening genioplasty to improve facial balance. This bony structure change will influence how the mentalis muscle interacts with the other muscles when you smile.

Jeffrey H. Spiegel, MD · Answer

You are concerned about the chin falling down when you smile? Are you happy with your appearance at rest? There's a difference. Motion issues are muscle based.

Zoran Potparic, MD · Answer

To evaluate chin size and balance with other facial features (nose, forehead) better, full face and profile photos would help. Based on these photos I am not sure that you would benefit from chin reduction?

Can by chin be fixed with Botox or will I need a reduction? (Photos)

Answers (4)

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