Some clients inadvertently wrinkle their chins either at rest or when they talk. Usually it is not noticed by the client until it is pointed out by someone else. Dimpled chins can also be seen after chin implants, or in clients with retrognathia. Atrophy of the subcutaneous fat and dermis overlying the muscles can contribute to a dimpled appearance. Because this dimpling somewhat resembles the skin of an orange, this deformity is called “peau d’orange” chin.
The paired mentalis muscles originate on the incisor fossa of the mandible and insert directly onto the dermis of the chin skin. Contraction of the mentalis muscles elevates the lower lip, producing a “pout.” Contraction also contributes to the mental crease.
Botulinum toxin is injected deeply into each muscle one injection site per muscle. A total of 4 to 10 botulinum toxin units is required (starting with 2 units at each injection point). Injections should be at least 1cm below the lower lip and always below the mental crease if present.
Place injections low in the chin, between the mental crease and the lower edge of the mandible.
Injection above the mental crease can affect the orbicularis oris muscle and may result in lower lip droop, or even drooling.