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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...

[ARTICLE] Reoperation and Pin Removal for Facial Contouring Surgery Require Careful Consideration

 

Facial contouring surgery is an effective method for improving facial shape. However, some individuals may consider revision surgery due to unsatisfactory results or complications. Therefore, an accurate diagnosis and a cautious approach are essential.

Facial contouring surgery, which includes procedures such as cheekbone reduction, square jaw reduction, and chin surgery, involves cutting and repositioning facial bones, which are then fixed in place using pins. While the healing time varies by individual, it generally takes about 3 to 6 months for the bones to fuse. Pin removal is typically possible after at least 6 months. However, since bones and muscles may adhere to the pins over time, it is generally recommended to remove them within 2 years.

The decision to remove contouring pins depends on individual needs. If a patient experiences persistent foreign body sensation or pain, if imaging tests reveal pin exposure, or if there are concerns about potential damage from external impact, removal may be considered. On the other hand, if the pins do not cause any discomfort, removal is not necessarily required.

Pin removal surgery for facial contouring requires a careful approach. A 3D CT scan should be performed beforehand to accurately determine the pin’s location and assess the bone condition. Minimally invasive incisions allow for safe removal and can help shorten the recovery period. After surgery, applying ice packs to minimize swelling and avoiding excessive physical activity can aid in recovery.

Dr. Kwon Soon Beom of Arc Plastic Surgery emphasized, “Pin removal and facial contouring revision surgery should be decided based on a detailed analysis of the individual's condition. Since the type and placement of fixation pins vary depending on the surgeon’s technique, it is crucial to undergo a CT scan and consult an experienced specialist to proceed cautiously.”

Medical Today Reporter Seongwoo Cho (ostin0284@mdtoday.co.kr)

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