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[ARTICLES] The “Witch’s Chin” That Becomes Prominent When Smiling—Restoring Natural Expression Through Mentalis Muscle Repositioning

The so-called “witch’s chin,” a condition in which the chin appears excessively elongated, pointed, or pulled downward when smiling, is not merely a cosmetic concern. In many cases, it originates from abnormal tension and misalignment of the mentalis (chin) muscle. While it may be unnoticeable at rest, facial expressions such as smiling or speaking can cause the chin to sink inward or be drawn downward, a result of overactivity of the mentalis muscle and imbalance with surrounding facial muscles. Recently, mentalis muscle repositioning surgery has gained attention as an effective solution for this condition. Rather than altering bone structure, this procedure repositions and re-fixates the overactive chin muscle to its proper anatomical location, structurally correcting the distortion that appears during facial expressions. Because it can address the witch’s chin deformity without bone resection, patient satisfaction has been notably high. Dr. Jang Yong-jun of ARC Plastic Surgery e...

*Surgery Diary - 4 - "Patient's health always comes first"

 [Doctor's Surgery Diary] - 4 - 

"Patient's health always comes first"


I'd like to tell you the story of my patient who visited from Europe for facial contouring surgery a while ago.

Usually receiving dental treatment, she came to Korea after completing all preparations with CT scans and medical treatment before entering Korea.

After arriving at ARC clinic, she took the pre-test for the final diagnosis before surgery, and the results are as follows.



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[1]

This is the X-ray panorama and the front view of CT.


1_1


1_2

 At first glance, it can just be passed. However, if you look closely, you slightly can see that the density of the right mandible image looks different from the normal left.

So, I checked the CT image again in a different mode.



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[2]

You can definitely see the difference between left and right.

2_1

2_2


The yellow drawing indicates the right side of the face, and the condition of the bone surface is completely different from that of the green drawing (left side), and it's slightly inflated.


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[3]

3

 In the cut-sectional picture, it is confirmed that the cortical bone, which determines the hardness of the bone, is very thin, and the status inside is also different from the normal spongy bone on the left.



***


As a result, facial contouring surgery was put on hold because normal progress seemed to be impossible.

In the cooperative dental clinic even suspected that it might be a malignant tumor, however, a professor of radiology at a university hospital strongly suspected it was a benign disease.

So, our clinic decided to proceed with taking a biopsy for her.

Eventually, she received a detailed diagnosis result and returned home safely without anxiety.

As seen in this patient, successful surgery requires comprehensive observation as well as the area and the strength of several experts.



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