Chin augmentation with silicone implants has long been considered as a simple and effective operation to increase chin projection. However, insertion and subsequent removal of silicone chin implant are not a reversible procedure, as commonly believed. Removal of silicone chin implant is usually associated with mentalis displacement, chin ptosis, and abnormal contraction of mentalis muscle, leading to "bizarre chin configurations" that are refractory to surgical treatment. I also experienced a patient who developed bizarre ball-like appearance on her chin pad after the removal of chin implant because of pain, which was inserted subperiosteally through an intraoral approach 6 months ago. In order to improve the chin deformity and decrease bizarre chin configuration aggravated by an abnormal overactivity of underlying mentalis muscle, fusiform skin with underlying soft tissue was excised vertically and chin pad was tightened. Postoperative 2 months photograph showed improvement of chin disfigurement, and vertical scar was acceptable.