A cleft chin, commonly referred to as a “butt chin,” is a distinctive facial feature characterized by a vertical indentation in the center of the chin. This trait is primarily genetic, passed down through families. Individuals who wish to modify this feature can achieve a smoother chin contour through various medical procedures. Both non-surgical and surgical options are available, depending on whether a temporary or permanent change is desired.
The Anatomy Behind the Cleft Chin
The appearance of a cleft chin originates from the underlying structure of the lower jawbone (mandible) and the muscles covering it. The mandible develops in two halves that typically fuse during fetal development. If this fusion is incomplete or results in a slight groove, it creates an indentation in the bone itself.
The soft tissues covering the bone also play a significant role, particularly the paired mentalis muscles, which elevate the lower lip and wrinkle the chin skin. In people with a cleft chin, the mentalis muscles may not fully cross or overlap in the center midline, leaving a muscle-deficient zone.
This gap between the muscle groups causes the skin to tether to the bone beneath, pulling it inward and creating the characteristic vertical groove. The depth of the cleft depends on the extent of separation in the underlying bone and the paired mentalis muscles.
Non-Surgical Modification Options
For individuals seeking a temporary solution, minimally invasive injectable treatments offer a quick and effective approach with little to no downtime. The two primary methods are dermal fillers and Botulinum Toxin injections.
Dermal Fillers
Dermal fillers, often composed of hyaluronic acid, are soft, gel-like substances injected directly into the depression. The filler adds volume beneath the skin, plumping the indentation and smoothing the chin’s contour. This quick procedure often takes less than an hour, with results visible immediately.
Results from hyaluronic acid fillers are not permanent, typically lasting between six and eighteen months. Once the body naturally absorbs the filler, the cleft gradually reappears, requiring repeat injections to maintain the smoother appearance. This temporary nature allows individuals to test the aesthetic change before considering a permanent solution.
Botulinum Toxin
Botulinum Toxin targets the muscle activity contributing to the cleft. It works by relaxing an overly active mentalis muscle that may be deepening the groove by pulling on the skin. By blocking nerve signals, the treatment forces the mentalis muscle to relax, which reduces dimpling and creates a softer contour.
Botulinum Toxin injections are effective when the cleft is largely due to muscle contraction rather than a deep bone groove. The effects are temporary, lasting approximately three to six months, and the procedure does not add volume. For some patients, combining Botulinum Toxin to relax the muscle and filler to add volume provides the most comprehensive non-surgical result.
Permanent Surgical Solutions
When a permanent solution is desired, surgical procedures can definitively alter the chin’s structure to eliminate the cleft. These operations require general anesthesia and are performed in an accredited surgical facility. The two main surgical pathways involve either reshaping the existing bone or placing a customized implant.
Genioplasty
Genioplasty, specifically the sliding or osseous genioplasty, is a bone-based procedure that addresses the chin’s shape and position. During this operation, a surgeon makes an incision, often inside the mouth to avoid visible external scarring, and uses a surgical saw to cut a segment of the chin bone. This segment can then be moved forward, backward, or adjusted vertically to change the chin’s overall projection and contour.
For cleft correction, the bony segment is reshaped, and the overlying soft tissues, including the mentalis muscle, are manipulated to close the central gap. While genioplasty can significantly soften a cleft, it may not completely eliminate a very prominent one, sometimes requiring concurrent fat grafting. The bone is then secured in its new position using small plates and screws.
Chin Implants
The alternative permanent method uses chin implants, typically made of materials like silicone or porous polyethylene. A chin implant is a customized piece surgically placed over the existing bone to enhance projection and smooth out irregularities. For cleft correction, the implant fills the indentation, creating a continuous, rounded contour.
The implant can be inserted through a small incision made either inside the mouth or discreetly underneath the chin. This option is generally less invasive than a sliding genioplasty, as it does not involve cutting the bone. Chin implants are designed to be permanent and offer a straightforward method to augment the chin while correcting the cleft simultaneously.
Recovery and Long-Term Considerations
Recovery from surgical chin modification requires careful adherence to post-operative instructions. For invasive procedures like genioplasty or implant surgery, the initial week is the most challenging, marked by noticeable swelling, bruising, and discomfort. Pain is typically managed with prescription medication during the first few days, transitioning to over-the-counter pain relievers within a week.
Initial swelling significantly decreases within the first two weeks, allowing most individuals to return to work and light activities. Strenuous exercise and contact sports must be avoided for four to six weeks to prevent complications. Full recovery, where final results are apparent, can take several months, typically lasting three to six months.
A common temporary side effect following surgery is numbness or tingling in the chin and lower lip area, particularly after a sliding genioplasty involving bone manipulation near nerve pathways. This sensory change is temporary and resolves as the nerves heal. Surgical results are considered permanent, though the natural aging process will continue to affect the surrounding soft tissues over decades.
The decision to pursue a permanent solution requires a thorough consultation with a board-certified plastic or maxillofacial surgeon. The surgeon evaluates the specific anatomy of the chin, including bone structure and muscle separation, to recommend the most appropriate technique. Choosing an experienced professional is paramount to managing expectations and ensuring a safe procedure with the best possible long-term outcome.