In this section, we will discuss how physicians are using BOTOX® and advanced dermal fillers to correct chins that have developed a crêping or orange peel look, as well as to correct deep lines between the chin and lips (mental crease), and elsewhere on the chin.
Note: Before undergoing any procedure discussed on this web site, make sure that your physician has extensive experience with the specific procedure. Medical schools have only recently begun to teach some of these procedures. As with any medical procedure there are varying degrees of risk involved. Please consult your physician.
Many individuals develop a rough skin texture on the front area of the chin that can look something like an orange peel, which is how it gets the name, peau d'orange (French for orange peel skin). This crêping of the skin is mostly a result of repeated contractions of the mentalis (chin muscle). Over time, the contractions may result in numerous thin, cross-hatched lines that give the chin this undesirable look.
Most physicians treat peau d'orange with small amounts of BOTOX® that are placed with one or two tiny injections at the origin of the mentalis muscle, which is at the bottom tip of the chin. A physician should be careful not to inject too much BOTOX® in this area, so as not to impact the ability to pucker the mouth. The intent is to gently relax the muscles in the chin, so that contractions are not as pronounced.
Over time, this treatment can have significant impact to eliminate or greatly reduce the crêping. If BOTOX® injections are repeated as close as possible to the time that the BOTOX® effects begin to wear off, then it is likely that treatments will be needed less and less frequently, with only minimal amounts of product over time. In effect, the thin grooves tend to fade away in many individuals after a few treatments.
Most physicians do not manage this condition with dermal fillers because the lines are so thin and because BOTOX® does such an effective job, in most instances, in treating the peau d'orange.
The mental crease is a horizontal groove between the chin and the area below the lips. The mental crease can be a single deep groove, or a combination of more than one line or groove. It gets its name because it appears to be a noticeable indentation or "crease" and it is formed near the top of the mentalis (chin) muscle.
The mental crease can contribute to an aging puckered look of the mouth area. It can also make an overly pronounced chin look even more exaggerated or "witch" like. In some instances where the mental crease is really deep (and other aging effects in the area are pronounced), a mental crease can make an individual look a bit like an aging cartoon character - sort of unnaturally old. Even in less noticeable occurrences, it can be an unappealing facial feature.
As with peau d'orange, BOTOX® is the first line of treatment for the mental crease by most physicians. Small amounts of BOTOX® are placed into the origin of the mentalis muscle, near the tip of the chin. A touch up treatment may be applied a couple weeks after the initial treatment (if the initial treatment is not effective enough). As with treatment of peau d'orange, physicians will take care not to over treat this area, so that an individual doesn't lose the ability to pucker the lips.
In addition to BOTOX®, many physicians will also place an advanced dermal filler such as Juvederm® or Restylane® along the mental crease to help fill in the crease. If the crease is very deep, then a physician may opt to use Radiesse®, Juvederm® Ultra Plus or Perlane® for deeper correction.
In some instances, individuals may have wrinkles on the chin that sort of fan up from around the jaw line on or around the chin. Most of the time, these wrinkles are very fine and shallow. Most experienced physicians will treat these wrinkles with small amounts of BOTOX®, the same way as described above in the peau d'orange and mental crease sections. BOTOX® will soften these wrinkles over time, which may result in the need for less frequent injections.
Depending upon the depth of the wrinkles, advanced dermal fillers, such as Juvederm® or Restylane® may be used, in conjunction with BOTOX®, to treat the wrinkled depressions. The combination of BOTOX® and dermal fillers can work together to extend the life of the dermal fillers.
Advanced Dermatology PC of NY & NJ Commack, Commack, NY
W. Grant Stevens MD FACS, Marina Del Rey, CA
Vincent C. Giampapa MD FACS, Montclair, NJ ~ Tina S. Alster M.D., Washington DC, DC
Vivian W. Bucay M.D., San Antonio, TX ~ David K. Funt M.D. NY, Roslyn, NY
George J. Bitar MD, Manassas, VA ~ Gilbert Lee MD, San Diego, CA
Jess Prischmann MD, Edina, MN ~ Carlos Wolf M.D., Miami, FL