[ARTICLE] ‘Witch Chin’ Caused by Chin Sagging: Requires Both Muscle Repositioning and Structural Correction

A condition where the chin droops downward and elongates the lower face—often making the facial expression appear sharp or imbalanced—is now commonly referred to as a “witch chin.” Previously known as mandibular protrusion or elongated chin, this condition is not just a cosmetic concern but can also cause functional discomfort, making careful attention necessary. While some cases of witch chin are congenital, many are acquired as postoperative complications. This is especially common after facial contouring surgeries, chin augmentation, filler injections, fat grafting, or implant removal. In such cases, the muscles around the chin may fail to reattach properly, or the mandible’s structure may become altered, leading to downward sagging of the chin. This often makes the face appear even longer when speaking or smiling, disrupting overall facial harmony. In these situations, “witch chin correction” can be achieved through a procedure called chin muscle repositioning surgery. This surgery restores the sagging muscles to their original position and secures them upward, reestablishing the natural curvature of the chin and minimizing asymmetry even during facial expressions. However, since the cause of witch chin may not be limited to muscle displacement and can also involve structural issues of the bone itself, an accurate diagnosis is essential. Depending on the patient’s condition, a combined approach involving both muscle correction and reshaping of the chin bone may be necessary. Therefore, a detailed consultation and diagnostic process, including CT imaging, should be conducted in advance. A personalized surgical plan that considers the overall balance and harmony of the face is crucial. Dr. Soonbeom Kwon of ARC Plastic Surgery Clinic advised, “Witch chin is not merely a cosmetic issue—it’s often the result of a complex interplay between facial muscles and bone structure. A customized treatment plan that appropriately combines muscle repositioning and bone correction, based on an accurate diagnosis, is necessary for optimal results.” – Medical Today, Reporter Seongwoo Cho (ostin0284@mdtoday.co.kr)