Some chins pucker into small dimples and bumps when you talk, pout or close your lips, a look often described as a pebbled, orange-peel or golf-ball chin. It comes from a small, busy muscle, and a low dose of Botox can calm it. At Shield Dental Care in Burke, VA, Dr. Ghorbani treats chin dimpling as part of our Botox service.
What causes a dimpled chin
The mentalis is a small muscle at the tip of the chin. It lifts the skin of the chin and pushes the lower lip up and out, for example when you pout. When it contracts hard, it pulls on the skin where it attaches and creates the dimpled texture.
For some patients there is a dental reason behind it. When the lips do not meet easily at rest, for example because the upper front teeth stick out, the mentalis tends to work overtime to close them, and the chin puckers with the strain. If that is what we see, we will talk about it with you, because Botox relaxes the muscle but does not change why it is working so hard.
How Botox helps
A small dose is placed into the mentalis, low on the chin and away from the lip. Relaxing the muscle smooths the pebbled texture and can soften how the chin puckers when you speak or close your mouth. Expert guidance describes small total doses for this area, usually in one or two injection points.
What Botox cannot do is change the size, shape or projection of your chin, add volume, or fix a chin that looks short or set back. Those depend on bone and soft tissue, not muscle activity.
An off-label use
No botulinum toxin product is FDA-approved for the chin. BOTOX® Cosmetic is approved for frown lines, forehead lines, crow’s feet and neck bands, and Dysport and Daxxify for frown lines only, so treating the chin with any of them is off-label. That is legal and common, and we explain it as part of consent before treatment.
What to expect
- Consultation. We look at your chin at rest and while you talk and close your lips, check how your lips meet over your teeth, and review your medical history and medicines.
- Treatment. One or two small injections into the chin. It takes a few minutes.
- Afterwards. You can go straight back to your day. We give you written aftercare, which includes not rubbing or massaging the area.
The change starts to show within a few days and builds over about two weeks. Movement then gradually returns over the following months. Treatment should not be repeated more often than every three months.
Side effects
A small bruise or tenderness at the injection point is the most likely thing you will notice. The side effects specific to this area come from the product reaching the muscles of the lower lip next door:
- a lower lip that looks uneven or droops slightly, or an uneven smile
- less control of the lower lip, which can make eating, drinking or speaking feel different
These wear off, and they are the reason we keep the dose low and the injections away from the lip. All botulinum toxin products also carry an FDA boxed warning: rarely, the effect can spread away from the injection site, causing trouble swallowing, speaking or breathing, vision problems or general muscle weakness, hours to weeks after treatment. These are medical emergencies. If they happen, get help immediately.
Who should wait
- Anyone pregnant or breastfeeding. Cosmetic botulinum toxin has not been adequately studied in pregnancy, so we recommend waiting.
- Anyone allergic to a botulinum toxin product, or with an infection or skin problem where the injections would go.
- Anyone with a nerve-and-muscle condition such as myasthenia gravis, Lambert-Eaton syndrome or ALS.
- Tell us if you take blood thinners, have recently taken aminoglycoside antibiotics, or have had any botulinum toxin treatment in the last four months.
The chin can be treated at the same visit as downturned mouth corners, since the muscles involved sit close together.
Frequently Asked Questions
Will Botox make my chin smaller or bigger?+
No. Botox relaxes the muscle that causes the dimpling. It does not change the size, shape or projection of your chin.
Will it affect how I talk or eat?+
It should not, at the low doses we use. If the product reaches the lower lip muscles, the lip can feel weaker or look uneven for a while before it wears off.
Why does my chin pucker when I close my mouth?+
Usually because the mentalis muscle is working hard to lift the lower lip. Sometimes that is because the lips do not meet easily over the teeth, which is worth checking at a dental exam.
Is Botox for chin dimpling FDA-approved?+
No. It is an off-label use for every brand. That is legal and common, and we explain it before treatment.