[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 explained, “In most cases, a witch’s chin that appears when smiling is caused by abnormal muscle movement. Therefore, an approach that regulates muscle tension and restores proper positioning is essential.” The witch’s chin can present in several forms depending on its underlying cause. Common types include cases where soft tissue descends, making the chin appear longer; cases where support structures weaken after facial contouring surgery, leading to sagging; and cases where the chin is excessively pulled downward and spreads laterally during smiling. In particular, the so-called expression-related witch’s chin, which becomes most noticeable during smiling or speaking, is primarily caused by muscular imbalance. For this reason, simple chin reduction surgery alone often fails to achieve sufficient improvement. To address these limitations, muscle-repositioning–based chin surgery focuses on reorganizing the attachment points and tension patterns of the mentalis muscle. This reduces excessive muscle activity during facial expressions and restores a natural anterior chin contour. When necessary, surgeons may also combine this approach with chin osteotomy or fine bone shaping to harmonize the overall facial contour. Dr. Jang emphasized, “Witch’s chin correction is not simply about shortening the chin or changing bone shape. To achieve high patient satisfaction, surgeons must comprehensively evaluate the direction of facial muscle movement, soft-tissue elasticity, and the structural support of the chin.” Prior to surgery, precise diagnosis is essential and includes 3D CT analysis of skeletal and soft-tissue structures, as well as evaluation of chin movement during facial expressions. Postoperatively, proper recovery management—such as swelling control, maintaining oral hygiene, avoiding excessive facial expressions, and attending regular follow-up visits—is critical. “Because the witch’s chin involves a complex interplay of functional and aesthetic factors, a meticulous approach by surgeons with strong anatomical understanding and extensive surgical experience is crucial,” Dr. Jang concluded. “When a natural and well-balanced chin contour is restored, the overall facial impression becomes softer, often with a noticeable rejuvenating effect.” Source: MediSobiza News (http://www.medisobizanews.com )