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Chin Tox

If you notice dimples on your chin when you smile or talk, chin tox may be your solution! Some refer to these dimples as chinulite, or orange peel chin. Also discussed is the line above the chin. Continue reading to learn about how tox works in the chin and if you are a good candidate.


What is Botulinum Toxin?

Botulinum toxin is a neurotoxin that has been prepared to relax or fully paralyze specific muscles they are injected into. How does the paralysis happen? The muscle contracting transmitters can't get out of their uber to get to the muscle, so they go back home. This causes no damage to any structures of the nervous or musculoskeletal system.

Botox, Dysport, Xeomin, and Jeuveau, are Botulinum Toxin Type A brands for cosmetic indication to treat the glabellar complex. Just like Kleenex, we often refer to the treatment as the brand name, Botox. "I'm going to get Botox." "Pass me the Kleenex." What we mean to say is, "Pass me the tissue," or, "I'm going to get Botulinum Toxin type A injected in certain muscles to relax them."


How Does Tox Make Chin Dimples/Chinulite/Orange Peel Chin Go Away?

Botox relaxes muscles. The muscle in the chin responsible for chin dimpling is the mentalis muscle. This muscle is often hyperactive in many people. If it contracts, it can create dimples in the skin. Relaxing the mentalis muscle relaxes the dimples.

Some people lack chin or jaw structure to hold their lower lip closed. Imagine your lower lip falling off a cliff. If there is adequate chin bone structure support, the chin muscle does not need to hold the lip muscle up to close the lips. If there is not adequate chin structure or support, the chin muscle has to work to keep the lower lip closed.

How do I know if I lack chin structure? Take a picture of your side profile. If you chin sits behind or at your lips, your chin lacks structure. If your chin protrudes the same as your lips or more, you do not lack chin structure.

If you lack chin structure, you will need to either get a chin implant or add filler to build structure prior to, or the same day as getting chin tox. If you chin tox without proper chin support, you will feel uncomfortable due to not having support to help close your lip. If your chin mildly lacks structure, you may get tox in the chin, though it is recommended to balance facial proportions by adding structure.


How Does Tox Make The Chin Line Go Away?

The line above the chin is called the mentalis crease. This is caused by keeping the chin contracted over a long period of time.

Will My Line(s)/Wrinkles Go Away?

If your skin only creases when you contract the muscle, Botox will relax the muscles, stopping the creases made by those muscles. Lines only visible by contracting the muscles are called dynamic lines. Lines visible at all times when the muscle is fully relaxed are called static lines. Static lines will soften with time depending on a variety of factors.

If your skin has static lines, your sheet (or skin) will need some ironing treatments (skin resurfacing ie. retinol, chemical peels, lasers, microneedling), in addition to stopping the creasing (Botox). The quality of your skin (younger, older, sun-damaged, sun protected), and how long the crease has been present will determine how long it will take for the line to go away. Some wrinkles or deep creases may never go away. This is why preventative botox, or baby botox, is on the rise. It stops the creasing before it happens. If the line is present at rest, the treatment is no longer preventative.

The mentalis crease is treated by relaxing the chin muscle, filling the line with dermal filler, and resurfacing the skin. It is common for this line to be very stubborn in nature in response to treatment.


What Are The Risks of Botox Between The Brows?

Injection Site Reactions

Injection site reactions are the most common risk. This includes bruising, swelling, minor pain, and sensitivity. Bruising does not commonly happen on the chin. Pain is very limited, though sometimes I compare the pain to plucking a thick hair in the area getting treated.

Smile Lower Lip Asymmetry

If tox in the chin is injected too far to the side or spreads to the side, it may affect the DLI (depressor labii inferioris). This will result in a significantly asymmetric lower face effect in the lip. The lower lip will make a nike swoop shape, instead of a normal smile. Google DLI botox to see what that looks like. Tox can be injected on the unaffected side to create more symmetry, or it will need to wear off. This risk can be decreased by an experienced provider who injects towards the middle of the chin, and not away from the center of the chin.

Google-able Scary Side Effects

If you google "Botulinum Toxin Side Effects" or Adverse Effects, you may read some scary reactions like difficulty swallowing, breathing, or talking, severe muscle weakness, or loss of bladder control. These are systemic results that can occur when upwards of 300-400 units of tox are used. Botulinum toxin is also used for hypertonic muscle conditions, like dystonias. Full limbs are treated with multiple hundred units of tox. The likelihood of a scary adverse event happening is extremely unlikely with cosmetic dosages of tox.


With this said, most patients will never experience any of the above adverse effects.


How Much Will Chin Botox Cost?

Some clinics charge by unit, while some clinics charge by area.

Most places charge by unit, and the price per unit or per area will vary based on the practitioner specialty, location, and many other factors.

In the chin, 6-20 units may be used depending on the strength of the muscle.


What Should I Do Before My Chin Botox Appointment (Pre Care)?

It is not very common to bruise on the chin, but avoiding blood thinners to prevent the risk of bruising is a good idea. Common blood thinners are alcohol, aspirin (and NSAIDs), fish oil, gingko biloba, ginseng, and garlic. If you are on a prescription blood thinner, it is possible to have injections as long as your primary care gives the okay and you are not in critical health.

If you have high anxiety or are really nervous, you may have a history of fainting with injectables, like getting needle pokes or giving blood. This is called vasovagal syncope. To avoid fainting, make sure you have eaten before the appointment, avoid coffee, and be hydrated. Communicate your fainting history to your provider. It helps to talk during the treatment, or be distracted. To avoid fainting, make sure you do not hold your breath. Relax your upper body. If you feel yourself about to faint, squeeze your abdominal muscles, and tell your provider so they can lay you down.

If you love to workout, plan your workout before your appointment. Sweating profusely is discouraged for the rest of the day, or 24 hours after tox.


What Are Chin Botox Appointments Like?

First your provider will assess your concern. They will estimate the amount of units and check your medical history. You should disclose any medical conditions, allergies, medications, and current pregnancy or breastfeeding information. The only people who should not get Botox are those who are pregnant, breastfeeding, severely or acutely ill, or who have some muscular weakness disorders.

They should take baseline pictures in consistent lighting of your muscles relaxed and contracted to store in your chart. They should educate you on the risks of the procedure. They should assess the characteristics of your muscles.

Your chin will be cleaned, and the product will be injected in 2-3 injection sites.


What Do Botox Injections Feel Like In The Chin?

The injection feels like a tiny pinch, maybe equivalent to plucking a thick hair in the area or extracting a pimple on the chin. You may or may not feel the fluid being injected. It has the consistency of water. It may or may not be cold. You may or may not feel a little bit of blood from this area after the injection. It is common and normal for blood to come out of an injection site, though the injection site may also not bleed.

You may feel like the treatment is working immediately, but that is just the presence of the fluid in the tissue. It takes a minimum of hours, usually a few days to begin seeing effects.

It is likely to feel sensitive after the injection. The chin is somewhat sensitive. The injection feels like a sharp poke, but the pain is not too sensitive.


What Should I Avoid After My Treatment?

There were general rules created when tox was developed for cosmetic use. These are 'do not sweat, workout, or use a sauna for 24 hours after, do not lay down for 6 hours after, and do not touch the area treated for an hour.' You can also use the muscles treated more after the treatment to help the tox kick in faster.


What Does Botox Feel Like Kicked In In The Chin?

Squeeze your hand tight. This is what your muscles do without Botox. Move your hand a little bit, but don't squeeze it tight. This is what Botox feels like. You won't be able to squeeze the muscles of the area tightly. You may be able to move them, but they will not squeeze tightly.

All toxin products take ten days to fully kick in. The strength is the greatest in the beginning, and will wear off with each passing week.

The chin does feel very different your first time getting lip tox. You may be surprised at how often you hold your chin muscles tight, because you will notice the inability to use the mentalis muscle with tox. The treatment should not impact expressions.


What To Expect From My Treatment

If you express your goals and expectations to your provider, your provider should be able to educate you on if those goals and expectations are realistic or not, and what they recommend.

If 20 units are used between the brows, and this is FDA approved to last 3-4 months, fewer units will last significantly shorter in comparison. It is not realistic to have the chin relaxed for more than three months. Chin lines will often not fully eradicate with tox and even filler. They often require a series of skin resurfacing (or ironing) treatments.


Which Tox Product or Brand Should I Pick?

I could make a whole blog post on this topic alone. Early in my injectable career, I set out to compare every single publication on all types of toxin for cosmetic use for efficacy. I spent over half a year trying to compare all of the studies, and learned that it was impossible to compare. The indicators of efficacy such as onset, duration, or improvement in lines are defined differently in every study. Most studies are funded by pharmaceutical companies that profit off the product and have bias. There can be flaws found in every single study, or findings can be disputed. The points used in-vitro to support a product as 'the best' are also not indicative of product efficiency. Accessory proteins and total protein load are terms used to make obtuse claims when there are no conclusive studies on these terms. I could ramble on end about this topic.


Here's my advice. I feel every patient should at some point try every product type. All of the products are so incredibly similar. Every patient has a different goal and different opinions on what they feel is the best outcome for them. Keep in mind placement of injection is greatly responsible for patient satisfaction. Placement is directly influenced by the patient's communicated expectations and feedback. Providers are also heavily influenced by the price they get the product for and politics associated with the companies. If you feel too pressured by a provider to pick a specific product, they are not the right provider for you.

Try whichever product makes you feel the most secure. Try the product the injector recommends for you. Try a different product if you weren't happy with the previous treatment (and communicate your concerns to the provider to alter their injection placement if not previously satisfied).


Am I A Good Candidate for Botox In My Chin?

You are not a candidate if you have some rare muscular disorders, expect tox to remove all of your lines, or do not accept the risks that come with the injection. Your first treatment is a learning experience for both you and your provider. You need to learn if it feels tolerable and if you see worthy results. Your provider needs your feedback to tailor the treatment. It is also very possible to not enjoy what chin tox feels like, and will take trying it with the right provider to learn if this is the right treatment for you. It is also very possible to not see significant results. If you are not okay with this, you are not a good candidate.

A good candidate is someone who is looking to soften the lines above the chin or soften the dimples on the chin. They may have static or dynamic lines. They understand and consent the risks of the injection. They understand they may or may not see significant results. They do not expect lines or dimples to fully eradicate immediately after tox kicks in. They are able to be local to the clinic ten days to two weeks later in case they need a touch up.


If you live in Southern California, specifically Los Angeles, Orange County, or San Diego, schedule to see Jasmin in Costa Mesa, California for Botulinum Toxin Chin. Consultations are free.

Belleviemedical.com/book-now


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