Excessive chin length from soft tissue - what can be done?

Question

Hi, in 2022, I had a chin wing, which brought my mandible forward and shortened my chin a bit. The bone is clearly vertically shorter, but you wouldn't know it from the outside. The soft tissue makes the chin look as long as it used to be pre-op. Also, my mentalis is still hyper active and requires botox. The latter of course does not address the tissue excess. My side profile looks fine until I laugh, t which point the soft tissue sags, giving me a witch chin. What can be done, and how? I'm 39. Thank you!

Anna Chacon, MD, FAAD · Answer

Hi, thank you for sharing the details and the photo—it really helps to understand your concerns.

It sounds like your chin bone (mandible) is now in a good position after the chin wing surgery, but the soft tissue overlying the chin is still contributing to the appearance of length, especially when you laugh. This is a fairly common issue after jaw or chin surgery.

There are a few approaches to address this:

Soft Tissue Contouring / Fat Reduction

Some patients benefit from submental liposuction or soft tissue debulking, which can reduce the fullness that contributes to sagging.

This does not shorten the bone but can help the chin appear more proportionate.

Skin Tightening Treatments

Non-surgical options like radiofrequency, ultrasound (Ultherapy), or laser-based skin tightening can improve tissue laxity over time.

These are gradual and subtle but can complement other procedures.

Combination of Muscle and Tissue Management

Botox in the mentalis helps reduce hyperactivity, which you’re already doing.

In some cases, targeted excision of redundant soft tissue (like a mini submental tuck or chin pad excision) can be combined with muscle relaxation for a smoother profile.

Surgical Revision

For more significant sagging, a revision procedure focused on soft tissue repositioning or tightening may be considered.

This is typically tailored to the amount of tissue excess and your aesthetic goals.

It’s important to remember that soft tissue responds differently in each person, especially in the late 30s. Often a combination of minimally invasive skin tightening plus Botox can improve dynamic movement, and small targeted revisions can enhance contour.

The good news is that your underlying bone structure is already favorable, so soft tissue adjustments can make a meaningful difference in your profile, especially when you laugh.

Excessive chin length from soft tissue - what can be done?

Answers (1)

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