Facelift pointy chin. How do surgeons avoid this?

Question

How do so many women end up with the 'Witche's' chin look after facelifts? I have seen some outstanding natural results but also some where the person looks really bizarre afterwards in chin area - extremely pointy crafted and unnatural 45degree vertical slant angle between neck and chin. How do surgeons do this is it an aggressive necklift that causes it? I really don't want to have this when I get my op - how do surgeons avoid this?

Jonathan Kulbersh, MD · Answer

Although having plastic surgery to the face does not create the phenomenon known as “witch's chin,” by not taking time to understand each patient's unique bone structure and musculature, some surgeons mistakenly accentuate disharmonies that are already present in the face. My training in facial aesthetics by some of the top plastic surgeons in the country means that I examine each patient's face thoroughly and develop a plan that works with their unique features and natural beauty. When it comes to facial plastic surgery, there is no “cookie-cutter” method. Decisions about where to lift and how much tension should be applied to each portion of the skin and muscle must come from thoroughly understanding that particular patient's anatomy.

A witches chin can occur if the chin region is not properly undermined and a step off forms in the area.

I hope this helps

A witches chin can occur if the chin region is not properly undermined and a step off forms in the area.

I hope this helps

Thomas McNemar, MD, FACS · Answer

A "witch's chin" deformity is generally related to sagging skin, fat, and other tissue that descends with age and accumulates around the chin. Facelift surgery doesn't cause a witch's chin if it wasn't present to begin with, but it can make an existing one look worse if it isn't properly addressed during the procedure. A chin implant, which is usually placed through an incision in the lower lip, can help lessen the appearance of a lax chin and smooth the jawline. Other options exist, as well, such as chin liposuction. If you're considering facelift surgery, ask your surgeon about it &mdash; specifically, ask to see before-and-after photos of patients with a similar condition.

Andrew Campbell, MD · Answer

A facelift will not cause a witch's chin, but the improvement to the jawline can make a pre-existing witch's chin look worse. There are a variety of causes and treatments for a witch's chin. See a surgeon that specializes in aging face surgery.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Witche's chin is a concern oftentimes voiced by patients. It occurs when there is laxity in chin and can be addressed with an implant procedure. Always consult with a board certified facial plastic surgeon.Best wishes,

Michael Boggess, MD · Answer

Hello.  Thank you for your question.  A Facelift procedure does not change the structure of the chin.  Chin ptosis (witch's chin) results from laxity of the soft tissues overlying an inadequately projected chin.  If someone has a witch's chin after a facelift, then they had a witch's chin prior to the facelift.  Tightening of the neck and jawline may just make it seem more apparent.  Placing a chin implant to improve the projection of the chin can provide improvement in this area.  This can be done at the same time as the Facelift or as an independent procedure.  I hope this information is helpful.  I would suggest that you seek a consultation with a board-certified facial plastic surgeon and allow them to assess your individual anatomy, concerns, and goals, in order to determine the best treatment plan for you.  Best of luck to you in achieving your aesthetic goals.

Brian K. Machida, MD, FACS · Answer

Facelift do not create witches chins, although I'm not sure if our definitions are the same. If a person has an odd shape to her chin, it was likely pre existing and due to her original anatomy.

Steven Wallach, MD · Answer

A witch's chin can be accentuated by placing the incision in the chin crease. By placing the chin incision behind the crease, and releasing the chin crease, can minimize the appearance of a witch's chin.

Sean Freeman, MD · Answer

milliemils9, chin ptosis or witches chin is a multifactorial problem that by definition has several causes and different fixes depending upon the cause. In general it can be fixed in a virgin patient and in a post op patient where this is an end result of the surgery typically that is due to a misjudgment by the surgeon in either approach or execution. To minimize your chances see an experienced surgeon that does "only faces" and has a lot of photos to review on their web site. Also review the video. Good luck!

William Portuese, MD · Answer

When patients have a pre-existing narrow  and pointy chin, a pre-jowl  implant  can be placed at the same time as the facelift to give added width only to the chin to help prevent the pointy look. If patient's have a weak and recessive chin profile, a wraparound anatomical style chin implant is used. Chin implants can be placed under local anesthesia as a stand-alone procedure, or under general anesthesia in combination with a facelift. For many examples  and more information including diagrams of the chin implants themselves, please see the link and the video below

Reza Momeni, MD, FACS · Answer

in a standard face lift, the chin is not touched.  He have to ask your self what else the patient had, or the surgeon did, that may have appeared to change the results on the chin.  In some cases, chin implants were used, and in others, fat grafting can be used.  If all that you are getting is a face lift, 1 would not expect the appearance  of the chin to change at all.  For course, often times, patients refer to their Neck as there chin.  To the surgeon from the standpoint of anatomy, the chin is the bony area below your lower lip.