What procedure would I need to fix my sagging chin? (Photo)

Question

my chin sags downwards when i smile or open my mouth. it is a great insecurity and I am looking to get it corrected and posssobly make my lower third look more balanced. Any suggestions?

Nelson Lee Novick, MD · Answer

At least from the photos provided, it would appear that the use of a robust HA lifting filler can increase chin projection and elevate it. The use of a robust HA volumizing filler can help to better define and straighten the jawline, and additional HA lifting filler can elevate the mental crease (the horizontal linear fold between the upper portion of the chin and the lower lip) that would likely appear to deepen once the chin is augmented.  You would be wise to consult with an experienced, board certified cosmetic dermatologist. In experienced hands, the entire treatment should take no more than about twenty to thirty minutes and yield immediate, on-the-spot results and engender little to no significant downtime. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

I understand why this bothers you, especially when the change is most noticeable with facial movement. A chin that appears to drop, bunch, or pull downward when smiling or opening the mouth is not necessarily caused by loose skin. It can be a dynamic issue involving the muscles of the chin and lower lip, the position of the chin itself, or the way the soft tissue moves over the underlying bone.

One possibility is overactivity of the mentalis muscle, which sits in the chin and helps control the lower lip and chin soft tissue. When it contracts strongly, it can create downward movement or bunching of the chin and make the lower third appear less balanced. In some people, the depressor muscles around the lower lip can contribute as well.

If muscle activity is the main issue, carefully placed Botox can sometimes soften the downward pull and improve the appearance when smiling or speaking. The dosing and placement are important, however, because these muscles are involved in normal lower-lip movement. Too much Botox or an injection in the wrong location can cause difficulty with smiling, speaking, drinking, or controlling the lower lip.

Another consideration is chin projection. If the chin is relatively retruded, the soft tissue may fold or move differently during facial expression. In that situation, appropriately placed chin filler—or, when there is a significant structural deficiency, a chin implant or genioplasty—can improve the underlying proportions. But adding filler won't necessarily correct a dynamic muscle problem, so I wouldn't use filler simply to try to hold the chin in place.

There is also a distinction between a chin that moves downward during expression and true skin or soft-tissue laxity at rest. If the chin looks relatively normal when your face is relaxed and the problem appears mainly when you smile or open your mouth, that makes a dynamic muscular component more relevant.

For that reason, I would not automatically recommend a surgical "lift" based on the description alone. The most useful assessment would be to evaluate the chin at rest and during smiling, talking, puckering, and opening the mouth, while looking at the mentalis and depressor muscle activity as well as the underlying chin projection.

If the issue is primarily muscular, a conservative Botox treatment may provide improvement. If there is also a structural/proportional component, addressing chin projection may complement that treatment. The key is identifying what is actually pulling the chin downward before treating it, because adding volume or performing surgery won't necessarily fix a problem that is primarily caused by muscle movement.

Nuket Eroglu, MD · Answer

Hello; You have a small chin; when it is necessary to compare with your face. The reason, you feel like your chin is hanging down is because; your Jawline area is too vague. Due to that, I will recommend for Jawline to you. Since the sides of the chin are very empty, it is necessary to sharpen the lower 1/3 of your face. This will provide proportional balance and smile aesthetics. I advise for Maili. It is an oxygen free, high-tech hyaluronic acid filler that remains intact for 12-14 months and does not cause nodulation. I'm sure that you will be very pleased.

What procedure would I need to fix my sagging chin? (Photo)

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