Q: Dr. Eppley, I have quite a big cleft/dimple in my chin and I 100% want to get rid of it. I just wanted to know how much this procedure will cost and is it straight forward. Any advice would be hugely appreciated. Thanks
A: Chin dimples and chin clefts have anatomical differnces but they both pose the same problem, getting rid of them 100% is not easily achieved particularly when they are ‘big’. The simplest and most straightforward method is by fat injections. A temporary elimination can be done by synthetic fillers. Fat injections offer the most straightforward approach for not overly deep chin dimples and clefts and are part of the treatment strategy when chin dimples and clefts are very deep. I would need to see some pictures of your chin to determine what is the best approach.
A chin cleft is an actual separation (defect) of the mentalis muscle with subcutaneous fat deficiency. In some cases they may even be a cleft in the underlying chin bone. A chin dimple is an isolated subcutaneous fat deficiency in the chin pad with only minor or negligible muscle deficiency.
Dr. Barry Eppley
Q: Dr. Eppley. I am interested in getting the large dimple removed from my chin. I am not sure where to turn to since it seems very few plastic surgeons perform this procedure. Please send me information in regards to how this surgery is done, how successful it is, and the possible cost. Thank you!
A: Thank you for your chin surgery inquiry. Chin dimple reduction/removal is usually done by an incision inside the mouth. (behind the lower lip) The key to a successful chin dimple reduction (sometimes a complete removal) is that you have to fill the muscular defect/indentation with some type of graft. This could be allogeneic dermis (off the shelf) or fat or dermal-fat grafts from the patient. In some cases, releasing the dimple and sewing the muscle together may suffice. This is done under local anesthesia or IV sedation as an outpatient procedure. Dissolveable sutures are used inside the mouth. There are no restrictions in eating or physical activity after surgery. Some mild swelling is to be expected but this will be gone in a few weeks.
The cost of chin dimple surgery is around $2500.
Dr. Barry Eppley
Q: I have a noticeable cleft in my chin and I was wondering what procedures can be done to remove the cleft and how invasive are they?
A: Soft tissue indentations of the chin can appear as either clefts or dimples. While both involve the chin soft tissues, they are anatomically different. Chin dimples are round depressions in the middle portion of the soft tissue pad of the chin and occur because of a central muscular and fat deficiency. There is no underlying bony abnormality. Chin clefts are vertical indentations that run from the middle part of the soft tissue pad down to the lower border of the chin. While they also have a muscle and fat deficiency (cleft of the soft tissues), they almost always have some notching of the lower border of the chin bone as well. (symphysis) Embryologically, it is easy to understand how a chin cleft occurs because of the union of the mandibular arches in the midline during development. It is harder to understand the origin of the central dimple although this likely represents an area of lack of epidermal cell adhesion during the final phase of merging.
Chin cleft surgery is best thought of as a reduction rather than a complete removal. There are two fundamental ways to perform the procedure based on the depth of the cleft and the tolerance for any outward scarring. An intraoral approach can be done where the the tissues under the skin are released from the bone, the cleft of the chin bone is filled in (if deep enough) and the muscles put back together to create more of an outward pout of the muscle. This works well for modest to moderate deep chin clefts. In very deeply grooved chin clefts, this will only provide partial depth reduction. Outward skin excision is more effective in these deeply grooved clefts but the creation of a vertical scar, even if the surrounding skin edges are smooth, may not be cosmetically acceptable.
Dr. Barry Eppley