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Botox Cosmetic seems to have a function for almost every area of the face. For years, neuromodulators were relegated just to their on-label uses, but as dermatologists and facial plastic surgeons find innovative purposes for these injectables, almost no area is off limits, including the chin. Enter: Chin Botox.

Like other muscle-heavy areas of the face, such as the forehead and eyebrows, the center of the chin can display signs of aging, particularly dimpled-looking skin. A few injections of your favorite toxin can make a significant difference in the divot department, leaving the chin looking less pebbled. “Although we have been using neuromodulators to treat dimpled chin skin for years, an experienced injector pays attention to it and treats the patient if they agree,” says New York facial plastic surgeon Lee Ann M. Klausner, MD.

Ahead, we tapped three experts for the full-court press on how neuromodulators work in the chin and what you can expect.

The Orange Peel Effect

It’s normal for the skin on the chin to take on an orange-peel appearance with age. Campbell, CA dermatologist Amelia K. Hausauer, MD explains that dimpled skin occurs when the chin muscles pull on the overlying skin. “As volume changes, these muscles become more active, which causes that orange peel appearance of the chin when making certain facial expressions, such as a pout,” she says. “Off-label use of neuromodulators in the chin is gaining awareness and popularity as more patients notice the results that can be achieved with neuromodulators in the lower face (not just FDA-approved locations).”

New York dermatologist Doris Day, MD adds that acne scars can also cause dimpled skin. “They may look mild in your teens or 20s but can appear as wrinkles or dimpled skin as the skin loses collagen and elastin.”

How Neuromodulators Smooth the Skin

Any injectable neuromodulator, including Botox Cosmetic, Dysport, Xeomin, Daxxify, and Jeuveau, is suitable to inject into the chin to help smooth things over. No matter where on the face neuromodulators are injected, they all work the same. The brain and facial muscle groups communicate through a compound known as acetylcholine. Neurotoxins block communication by halting the release of acetylcholine and preventing the muscle from contracting to limit wrinkles and create smoother skin. Once the neurotoxin takes hold in the mentalis muscle (between the lip and chin) via small injections, movement is drastically limited, and the skin starts to smooth out.

It takes a few days to one week after the injections to see a difference in the skin, lasting anywhere from three to four months. “The return to full function is gradual, beginning at three months and fully wearing off at four to five months, depending on the patient’s age,” Dr. Klausner says. The key to achieving good results is precise placement and proper dosing. Otherwise, you can knock out too much muscle movement and impair the thin muscles around the mouth, which Dr. Klausner shares can result in an asymmetric smile. Younger patients usually need treatment less often.

Who Chin Botox Works Best For

Dr. Day says injecting the chin with neuromodulators works well for anyone noticing their chin getting smaller and bothered by dimpling. But even if cobble-stoned skin is problematic, Dr. Hausauer turns down some patients with weak muscles around the mouth who are at risk for smile asymmetry or difficulty speaking or eating. “Luckily, this is quite rare.”

Dr. Klausner says chin implant patients are also good contenders for Chin Botox. “I’ve seen patients with chin implants who have a defect in the muscle from the surgery. They benefit from this treatment as well.”

What Else to Consider

Using injectables to correct the skin on the chin is one thing, but you should also consider any volume loss in the lower third of the face. As Dr. Hausauer explains, with age, there’s a lack of fatty support and skeletal bone changes which means the muscle has to work harder hence the skin pulling. “Filler or fat transfer to the chin can add structure to those lacking it.”

To keep the lower face looking harmonious, your dermatologist or plastic surgeon should always assess the midface and jawline, which Dr. Day says can affect the appearance and movement of the chin. When other issues affect the chin, you may require additional treatments. “That varies from patient to patient but could include addressing the corners of the mouth, platysma bands or a square jaw. I always evaluate the face so a whole and even consider the eyebrow complex,” Dr. Klausner adds.



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