In short. Dimpling, a soft cleft and an orange-peel surface come from the mentalis muscle pulling on the skin. Why they are treated as muscle, not volume.
Key points
- A gathered surface is a muscle finding.
- A short chin is a volume or a bone finding.
- The two can coexist, and naming which is which is what stops a plan from making one of them worse.
A dimpled chin, a soft cleft and an orange-peel surface over the chin are the same kind of finding: they come from the mentalis muscle and the way it pulls on the skin above it. They are not a shortage of volume, and treatments that add soft tissue volume tend to make them more obvious rather than less.
What the muscle does
The mentalis sits at the front of the jaw and attaches to the skin of the chin. When it contracts it lifts that skin and presses the lower lip forward, which is the movement you make when you drink from a cup or express doubt. Because the skin over the chin is tethered to the muscle and to the bone beneath it, the contraction gathers the surface rather than sliding it smoothly, and that gathering is what produces the dimpling.
Dimpling, cleft and orange peel
The three are distinguished by when they show. An orange-peel surface appears only when the muscle is working, and disappears at rest. Dimpling behaves the same way and is usually deepest on the side where the muscle is stronger. A soft cleft is present all the time, because the skin is tethered along the line where the two halves of the muscle meet, and it is a shape finding as well as a movement finding. The assessment separates them because the answers differ, and the answer for a soft cleft usually involves both the muscle and the shape.
Why volume makes it worse
Adding material beneath skin that is already being gathered increases how far the skin has to travel over the surface, so the folds read deeper rather than softer. Patients who ask for a smoother chin and receive volume are frequently the ones who report that the texture is more noticeable afterwards. That is not a failure of the material; it is a plan aimed at the wrong finding.
Treating it as muscle
Because the finding is muscular, the route that addresses it relaxes the muscle. That softens the surface on movement and leaves the shape of the chin exactly as it was, which is why it does not substitute for anything that changes projection. The effect fades as the muscle recovers, so it is repeated rather than done once. Where the surface and the profile are both complaints, they are separate findings with separate routes, and a plan that names both is more useful than one that tries to answer them with a single treatment.
Surface and shape are different findings
A gathered surface is a muscle finding. A short chin is a volume or a bone finding. The two can coexist, and naming which is which is what stops a plan from making one of them worse.
Texture changes that need assessment
- A lump or firm area that has appeared and is enlarging or tender.
- Redness, warmth or discharge over the chin, with or without fever.
- A change in sensation of the lip or chin, or a rash that is spreading.
Frequently asked questions
Is a cleft chin the same as dimpling?
They share a cause and differ in how much tissue is involved. A soft cleft is a groove where the two halves of the muscle meet and the skin is tethered to the bone beneath, and it is present all the time. Dimpling and an orange-peel surface are the same muscle gathering the skin as it contracts, so they appear on movement. The first is a shape finding, the second a movement finding, and they are not treated identically.
Why would adding volume make dimpling more obvious?
Because the surface is being gathered by the muscle rather than being short of volume. Placing material under skin that is already being bunched increases the distance the skin has to travel over it, so the folds deepen rather than soften. This is the opposite of what someone asking for a smoother chin expects, and it is the reason the surface is assessed before any volume is planned.
Does treating the muscle change the shape of the chin?
No. Relaxing the mentalis changes how the skin over the chin is gathered and how the surface reads on movement, and it adds nothing and removes nothing. The position of the chin on the profile is exactly where it was. Where a patient wants both a smoother surface and more projection, those are separate findings and are usually planned as separate steps.
Risks & Limitations
- Altered sensation in the lower lip or chin is the signature risk of this area, and how much of it recovers cannot be promised.
- Added volume can be dissolved. A change made to the bone cannot be undone.
- Swelling settles over months, and a result is judged at a year rather than in the first weeks.
- Further treatment, including revision, may be needed.
When to Seek Care
- Difficulty breathing or chest pain — seek emergency care immediately.
- Numbness of the lip or chin that is new, spreading, or not recovering.
- Severe pain, skin turning white or dusky, or a change in vision after an injection.
- Fever with spreading redness, warmth or discharge from a wound.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.