Q: Dr. Eppley, I have a mild chin cleft that I would like corrected. I have attached a picture so you can have a better understanding. It drives me nuts when I smile as it is so visible particularly in pictures.
A: By your picture what you have is a chin dimple not a chin cleft. That may seem like a semantic difference but anatomically there are somewhat different entities and are treated a little differently. A chin dimple that presents itself when you animate (smile) represents a defect in the mentalis muscle that covers the chin. Lacking fat underneath it and a defect in the muscle, the skin is pulled inward acting like an adhesion to the underlying tissues. Conceptually, volume needs to be added under to dimple to push it outward. This can be done by a number of ways but the simplest method is to place some injectable fillers (e.g., Juvederm) underneath the chin dimple. While this simple office treatment will not be permanent it will last 6 to 9 months and will answer the question whether the ultimate placement of fat injections would be the best long-term treatment of your chin dimple correction.
Dr. Barry Eppley
Q: Dr. Eppley, I would like to have a chin dimple made to look like Adele’s chin. Can you do that and how is it done?
A: What you are asking about is chin cleft creation surgery not the creation of a chin dimple. In looking at the chin of the singer Adele, careful assessment will show that what she actually has is a chin cleft and not a chin dimple. This chin feature distinction is not really semantics but two distinct anatomic entities. A true chin dimple appears on the center of the chin pad above the lower border of the bone and is a circular indentation. It occurs as a result of an underlying soft tissue (fat) deficiency without a mentalis muscle defect. Conversely a chin cleft appears on the lower end of the chin pad and is a vertical groove that crosses the lower border. It can have a wide range of depths from just a very shallow hint of a line to a very deep groove. Chin clefts are the result of an actual mentalis muscle defect (midline separation) and may actually involve a groove in the underlying chin bone as well.
In the surgical creation of chin dimples and clefts, this distinction is critical as the technique to do them is different. As a general rule, successful creation of a chin cleft is more reliably done than that of a chin dimple. Chin cleft surgery is best done from a small incision on the underside of the chin, a groove is made in the bone, a strip of soft tissue including muscle is removed above it and the underside of the skin sewn down to the groove made in the bone. It can also be done intraorally but it is technically more difficult and I have found it to be not quote as reliable in terms of getting a good result. This is a small outpatient procedure that can be done under local anesthesia or IV sedation. Other than some mild chin swelling there is no real recovery afterwards. Expect that to see the full depth of the chin cleft result to take about six weeks.
Dr. Barry Eppley
Q: I am interested in having a dimple put into my chin. I do modeling and I feel it would add more definition to my face. What do you think? Will it be easy to tell I have had it done? How long does it take to heal? Will I need bandages on it?
I have attached a few images of myself to show you what I look like. I have also added a picture of a gorgeous girl I know who has a dimple that I really like. Will it look anything like hers?
A: Creating some form of a concavity in the chin, whether it be a dimple or a cleft, is about providing some character and uniqueness to a facial feature. I don’t think it necessarily creates more definition to the face but it provides a highlight feature that many people find attractive. In creating this chin feature it is important to differentiate between a chin dimple and a chin cleft. They look different and are surgically created with different nuances of the same basic procedure. You have stated your interest in a chin dimple which is a rounded indentation in the middle portion of the soft tissue chin pad. The picture of the model whose chin you like, however, appears more like a chin cleft which is more a vertical indentation from the middle of the soft tissue chin pad down to the edge of the bone. Both can be created, it is just important to know exactly what you want.
Whether it is a chin dimple or a chin cleft, the operation is done from the inside of the mouth. It is a very simple procedure from the perspective of what it is like to go through and recover. It is usually done under local anesthesia or IV sedation. There are no external bandages after surgery. The sutures inside the mouth are dissolveable so their removal is not necessary. There are no restrictions after surgery in terms of eating or activities. There is some chin swelling but no bruising. The chin dimple or cleft can be seen immediately after and it may initially be a little more indented or clefted that it will be when the swelling goes down. It will take about two to three weeks until the chin feels completely normal again.
Dr. Barry Eppley