Q: Dr. Eppley, Just wanted to follow-up with you regarding my Mentalis Muscle Resuspension Surgery. I wanted to makes sure I understood what you told me during our consultation. You made the following points:
1) That my chin and lower lip sag are “fixable”.
2) Based on my chin x-ray, you said that the screws were placed
way too low to fix my issue. You would place screws much higher
between tooth roots
3) Also you would dissect a much larger area (under and around
the chin) to get enough lose skin to pull up and overcorrect issue as
there will be some sagging after surgery
4) And during the operation you would be able to place my head in
an upright position so you can confirm that my lower lips are way
above my bottom teeth before you attach the anchor then after
attachment confirm it has been raised high enough.
5) Lastly you recommended a V-Y lower lip mucosal
What kind of results have you had with similar situation as mine? Do you usually have good luck?
A: Correction of a sagging chin and lower lip is challenging and the best results come when every available technique is done for it. The entire chin tissues must be mobilized and the anchorage point for the muscle must be high with a screw(s) placed between the tooth roots. While this can lift sagging chin tissues, it does not always guarantee that the lower lip will end up elevated. Raising the lower lip is very difficult to sustain and that is why I usually perform a soft tissue elevation/roll out of the lower lip as well. Reattaching the mentalis muscle higher is no guarantee that it will push up the lower lip. It may seem that way when one pushes the chin tissue up on the outside with their fingers but it does not work that way in surgery.
My experience has been with these techniques that everyone gets improvement but it is the lower lip position that can remain the most incomplete part of the repair.
Dr. Barr Eppley