Creating a Three-Dimensional Side Profile: How to Address a Weak Chin and Double Chin at the Same Time

"Why does your side profile feel 2% lacking? What is a weak chin?"



A weak chin refers to a condition in which the lower jaw is relatively smaller than the upper jaw or set back, so the chin does not project enough when viewed from the side. In terms of appearance, the lower face may look weak, and medically it can be accompanied by various discomforts.



Depending on the position of the chin and the degree of mouth protrusion, the side contour of the face may look awkward. In such cases, procedures for protruding mouths or orthognathic surgery may be considered,

but even chin surgery alone, without affecting dental occlusion, can bring significant improvement.



I will explain the standards used to diagnose the ideal chin position, as well as the advantages and disadvantages of various methods for improving the shape of the chin.



In addition, we will look at actual before-and-after case photos to confirm changes in chin position and the improvement effect on the double chin.



Sometimes, when watching performers on TV, you may notice an unnatural line in which the chin and double-chin area seem separate, as if there were a small pouch attached to the chin. In many such cases, it is likely that only an implant was inserted into the chin.



Diagnosis



Before going into detail about chin surgery for improving the facial side contour (profile), I will first explain the ideal side contour of the face.





The "Ricketts line" connecting the tip of the nose and the chin

The side contour can be analyzed using various reference points, but the most commonly used standard is to look at the position of the lips based on the line connecting the tip of the nose and the chin (the Ricketts line).

It is generally defined that an ideal side contour is when, based on the Ricketts line, the upper lip is about 4 mm behind it and the lower lip is about 2 mm behind it. However, in East Asians, the mouth tends to protrude slightly, so I do not think a side profile is awkward simply because the lips touch the Ricketts line.

However, if the mouth protrudes somewhat excessively or the chin is set back significantly, the side contour of the face may look awkward and may create a somewhat pouting impression.

Looking more specifically at the shape of the chin bone,



compared with Normal (a typical chin shape), there are cases where the chin bone volume is small (Microgenia),



cases where the chin volume is excessive (Macrogenia),



cases where the chin is long but set back (Long Retrogenia),



and so on.

"Could I have a weak chin too? Self-check checklist"

When the tip of your nose and chin are connected, do your lips touch the line a lot?

When you close your mouth, do pebble-like (walnut-wrinkle) folds form on the chin?

Does your double chin look especially severe compared with your actual weight?



Summary

1. Main features of a weak chin



Side-profile silhouette: The lips appear to protrude more than the line connecting the tip of the nose and the chin.

Unclear jawline: The boundary between the chin and neck looks blurred, and a double chin is likely to form relative to actual weight.

Shape of the mouth: Even at rest, the mouth may not close easily, or when closing the mouth, tension in the chin muscles can create "pebble-like" wrinkles.



2. Why does it happen?



Skeletal cause (congenital): The lower jaw bone may be naturally small or underdeveloped.

Dental influence: The upper front teeth may protrude too much, making the lower jaw appear relatively small.

Lifestyle habits: During growth, mouth breathing or thumb-sucking habits can also affect jaw development.



3. Discomforts that a weak chin can cause



A weak chin can affect not only appearance but also health.

Snoring and sleep apnea: If the lower jaw is pushed back, the airway can become narrower, making breathing during sleep uncomfortable.

Malocclusion: If the upper and lower teeth do not fit together properly, chewing ability may decrease.

Temporomandibular joint pain: Because the jaw position is unstable, stress is easily placed on the jaw joint.



4. How to self-check



Stand sideways in front of a mirror and check.

• When you connect the tip of the nose and the chin with a ruler, do the lips touch the ruler or protrude beyond it a lot?

• When you close your mouth, do wrinkles form on the chin like a walnut shell?

• When you are expressionless, does the mouth seem open and the jawline look as if it is connected to the neck?



Ways to improve it

. Filler injections (a simple procedure)



This is the simplest method of adding volume with an injection.

Advantages: You can return to daily life immediately.

Disadvantages: Over time it is absorbed, so repeat procedures are needed. In particular, non-dissolving fillers are difficult to remove later and may cause the skin to sag. Also, if fillers are used repeatedly, a "bone erosion" phenomenon may occur in which part of the chin bone is worn away, and there is no effect on improving the double chin.

. Chin implant insertion (a relatively simple surgery)



This surgery inserts silicone or similar material through a small incision inside the mouth.

Advantages: Permanent and relatively simple.

Caution: A "bone erosion" phenomenon may occur, in which the chin bone that contacts the implant becomes worn away. In addition, if the implant shifts upward or changes position, it can create an unnatural line with the chin protruding only in one area.

. Chin advancement surgery (a fundamental solution)



This method involves cutting the chin bone and moving it forward before fixing it in place.

Advantages: It is the most effective for improving a double chin. This is because when the bone is pulled forward, the muscles under the chin are also pulled taut. Since your own bone is used, there is no foreign-body sensation, and customized adjustments according to the chin length (lengthening or shortening) are possible.

Disadvantages: It requires more surgical skill than other procedures.

1. Procedure - Filler injection



To improve the position and lack of volume in the chin bone, a simple filler injection procedure can be considered as a way to increase the volume of the soft tissue.



Filler injection procedures are simple and allow immediate return to daily life after treatment, which is why many people actually prefer them.



However, beyond the advantage of simplicity, filler injection procedures also have several disadvantages as follows.



Disadvantages

1. Safe fillers are not permanent, and after a certain period, most of them are absorbed.

2. Fillers can cause erosion of the chin bone, resulting in part of the chin bone being worn away like a crater.

3. Non-dissolving fillers cannot be completely removed even if removal is desired, and may cause the chin skin tissue to sag downward.

4. The chin volume is replenished, but the double-chin line caused by the chin being set back is not improved.

When chin filler has been injected, the chin area is worn away like a crater



2. Simple surgery - fat grafting



Although it is a bit more cumbersome than filler procedures, it compensates for the drawbacks of filler injections and uses your own tissue, which is one of the chin procedures I personally think very highly of.



3. Simple surgery - implant insertion



Chin implant insertion is a relatively simple surgery in which an implant is inserted in front of the chin bone through a small incision inside the mouth, under local anesthesia or sedation.



There are various types of implants used in the chin area,



depending on the surgeon, the preferred type of implant, the incision site, and whether the implant is fixed to the bone or not may differ.



Therefore, there can be many differences depending on the surgeon performing the procedure.



Implant insertion is also a relatively simple surgery, so it is very common and widely performed.



However, while chin implant insertion has the advantage of being simple, it also has disadvantages.

Disadvantages

1. Partial erosion occurs in the chin bone that is in contact with the inserted implant, causing it to wear away.

2. If the implant is not fixed, the inserted implant may shift upward or become displaced.

3. The chin volume is replenished, but the double-chin line caused by the chin being set back is not improved.



As can be seen in the CT images below, the bone in the area where the chin bone and the implant were in contact has eroded and worn away. In addition, it can be observed that the implant is not located at the chin area but has shifted upward from the chin.

CT showing the chin bone worn away where it contacted the implant









As can be seen in the CT below, one side of the implant had shifted upward and become tilted, and during revision surgery it was fixed in the correct position. In the postoperative CT on the right, the bone in the area that had previously contacted the implant can be seen worn away.







4. Chin osteotomy and advancement



As a more fundamental method, this is a surgery in which your own chin bone is cut horizontally or in a curved shape, then moved forward and fixed.



Depending on the length of the chin, various methods are applied as shown below.



If the length is appropriate, the bone is cut horizontally and advanced as is,

if the length is long, a sandwich osteotomy is performed, the middle portion is removed, and the lowest chin bone is moved upward, advanced, and fixed,

if the length is short, bone from the lower jaw cut from the surrounding area is grafted into the osteotomy gap to lengthen it while advancing.





If the chin length is appropriate - horizontal osteotomy followed by advancement as is

If the chin length is short - after horizontal osteotomy, bone cut from the surrounding lower jaw is inserted in between to lengthen it while advancing



If the chin length is long - after a sandwich osteotomy, the middle portion is removed and the lower chin bone is moved upward, advanced, and fixed

Why is "bone advancement surgery" good for a double chin?

When watching celebrities on TV, have you ever seen an unnatural look where only the chin sticks out like a pouch while the flesh under the chin remains the same? This usually happens when only an implant is inserted.

In contrast, chin advancement surgery moves the bone itself forward, fundamentally pulling up the sagging tissue under the chin. It works like pushing the tent pole forward to stretch the fabric taut.



The relationship between chin position and a double chin



Category	Chin filler / fat grafting	Chin implant insertion	Chin advancement surgery (osteotomy)
Features	Non-surgical / simple	Implant (silicone/Gore-Tex) insertion	The patient’s own bone is cut and moved
Advantages	Immediate effect, quick recovery	Clear volume, permanent maintenance	Improves double chin (fundamental), no bone erosion
Disadvantages	Absorption and periodic procedures needed	Possible bone erosion, positional changes	Surgical burden (general anesthesia required)



Actual cases - chin advancement surgery performed

These are actual cases.



Case 1.

This is an actual surgical case, comparing photos before surgery and one year after surgery.



In the shaded area, you can see the improvement in the double-chin line and the change in the side contour based on the Ricketts line.



Case 2.

This is an actual surgical case, comparing photos before surgery and one month after surgery.



In the shaded area, you can see the improvement in the double-chin line and the change in the side contour based on the Ricketts line.



Case 3.

This is an actual surgical case, comparing photos before surgery and one week after surgery.

In the shaded area, you can see the improvement in the double-chin line and the change in the side contour based on the Ricketts line.

The images below were created with AI.

AI-generated image - How to improve a long weak chin - shorten it while moving it forward

• Schematic of how to improve a long weak chin - reduce the length and move it forward to fix it



In this post, I briefly introduced the various methods of chin contouring for improving the facial side contour (profile).

I will cover the details of each method in separate, more specific posts later.