Q: Dr. Eppley, I have attached a picture of myself so you can see my chin. I do have a “ball” on the chin but I do not know what causes that. Each surgeon seems to have a different opinion about it. One surgeon told me it is caused by soft tissue and the mentalis muscle and that he can spread out the mentalis muscle and remove soft tissue to flatten the ball a little bit. But that worries me as I already have some dimples when I smile. I am afraid it will show irregularities on my chin (bumps, dips). How is it possible to know if it is the bone or the muscle and soft tissue causing this? Another surgeon said it would be best to shave the ball a bit (he thinks it’s caused by the bone); what are my options? and the risks? Thank you so much.
A: The one thing that I can tell you for certain is the ball on the end of your chin is all soft tissue and not bone. That is the confluence of the paired mentalis muscle and subcutaneous fat in the midline of the soft tissue of the chin. It is never a bony-based problem. The only way to reduce it is by intraoral soft tissue excision, there is no such procedure as ‘spreading out’ the mentalis muscle. You are correct in assuming that any deflation of the ball does pose risks of overlying soft tissue irregularities, particularly if fat is removed as this lies closest to the underside of the skin. If some of the deeper muscle is removed and swen down to the bone, this is the safest method of reducing its promienence and avoiding any obvious statis or increased dynamic chin dimpling.
Dr. Barry Eppley