Botox chin: the "orange peel" chin, why and how?

The chin is one of the eleven areas of our atlas of botulinum toxin by area of the face. This page explains where the "orange peel" chin comes from, what the toxin can and cannot do, why it is an off-label use in France, and what its risks are. It does not replace a consultation.

Why is the chin treated?

The mentalis is a small paired muscle that arises from the bone of the lower jaw¹ and attaches to the skin of the chin. When it contracts, it puckers the skin of the chin. If it is very active, the skin takes on a dimpled appearance, like "orange peel" or a "golf ball"^1,2.

Botulinum toxin temporarily relaxes this muscle, which smooths the chin in motion. It is the main muscle targeted to treat this appearance¹. An Italian expert consensus published in 2026 identifies the orange peel appearance and overactivity of the mentalis as the indications with the strongest agreement². The "dimpled chin" also appears in the 2004 and 2010 consensus documents^3,4. The 2010 one was written by an expert board convened around one manufacturer’s product⁴.

What the toxin does not do: it does not change the shape or bony projection of the chin, and it does not correct sagging skin in the lower face. Downturned mouth corners depend on another muscle, the depressor anguli oris, which the same consensus addresses separately².

When is the toxin used?

There are no official criteria, since no French label provides for this area. The expert consensus documents concern an overactive mentalis and the resulting orange peel appearance². They stress individual assessment of each patient³, and the 2026 consensus highlights the value of ultrasound to identify each person’s anatomical variations².

The contraindications in the labels apply whatever the area: allergy to the toxin or to a component of the product, a generalised disorder of the muscles and of the junction between nerve and muscle (myasthenia gravis, Lambert-Eaton syndrome), an infection at the injection site^5,6. Treatment is not recommended during pregnancy or breastfeeding^5,6.

Which toxin for the chin?

The type A toxins approved for aesthetic use in France cover frown lines and, depending on the product, crow’s feet and forehead lines⁶. None provides for the chin. The short-acting botulinum toxin (serotype E) is approved for frown lines only, in the European Union and in Canada^5,7. For this area, any injection is therefore off-label. The consensus documents cited concern type A toxins^2,3,4.

Is it right for me?

Your doctor will look at your chin at rest and when you close your mouth, the position of your lips and the shape of your jaw. A chin that tenses because the lips have trouble closing, for example because of the position of the teeth, may call for a dental or orthodontic opinion as much as an injection. They will take into account your medical history, your treatments and any pregnancy plans.

The neighbouring lip area is covered on the page about botulinum toxin around the mouth; the jaw on the page about the masseter, and the neck on the page about neck bands.

Questions to ask your doctor: is this treatment off-label? What result is reasonable? Could the way I speak, eat or smile change? How long does the effect last, in your experience?

Onset and duration

No label gives an onset or duration for the chin, and the abstracts of the consensus documents consulted provide no figure^2,3,4. We therefore do not give one. For the approved areas, type A labels describe an improvement within a few days and an effect lasting up to about 4 months⁶.

How these timelines work in general is explained on the page about how long botulinum toxin takes to work.

What are the risks in this area?

A 2023 anatomical review cites two side effects of a poorly placed injection in the chin: incomplete closure of the mouth, and an uneven smile caused by drooping of the lower lip¹. The 2026 consensus points out that the lower face is a delicate area, because its muscles have important functions, which increases the risk of side effects². The injection-site reactions described in the labels (pain, swelling, small bruise) are also possible⁵. A muscle that is only partly relaxed can also leave the chin bumpy, through paradoxical bulging²: the page on a dimpled or bumpy chin after an injection explains what to do. These effects are temporary.

Difficulty swallowing, speaking or breathing requires immediate medical attention⁵. If your chin feels stiff or your smile seems different after an injection, the page on the chin after an injection describes the most common situations.