Q: Dr. Eppley, I am interested in chin ptosis correction. I originally had a chin implant ten years ago. Following an accident in nine years later the implant moved and it was changed with a new implant last year. This new chin implant was much too large for my face and was removed six months later. Following the removal of the implant I developed chin ptosis with too much lower teeth show when I opened my mouth.
I subsequently had a chin ptosis corrective surgery three months ago with bone anchors. The result from the chin ptosis surgery is substantially the same as before the surgery but now my lower lip goes in on the right side when I smile or I speak or when I open my mouth my lower teeth sees too much. When I talk I have trouble to articulating my words, maybe because of the new position of my mouth. I saw the surgeon again last month for this problem again and he did Artecoll to correct the irregularity of the chin and offered me another surgery to remove the extra skin under the chin and to do Botox to correct the defect of the lower lip.
I did not accept these proposals because I want to have first your opinion and advice. The surgery to remove the extra skin under the chin makes me nervous because now when I open my mouth my lower teeth show too much and I fear that this problem will be accentuated with this surgery. Now I really need your advice and your help. I’m sure you could find a solution to restore my chin. I read your publications regarding chin ptosis and possible treatments could be a small implant or 2 or 3 mm osteotomy for support under the chin could help or neck lift. I have seen before and after pictures on your web site concerning this surgery in which you made all this women much more beautiful. Thank you very much for your answer.
A: The first thing is I would not rush into any surgery immediately. It has just been three months and your tissues are still healing. If too much lower tooth show is the primary concern any type of submental tissue removal would not help in that regard. Given your history of multiple chin implants and now being ‘implantless’, it appears that an important part of getting your lip back up may be the placement of a new smaller implant to help drive the tissues upward or possibly even making the vertical length of the chin shorter. Lower lip sag is a very difficult problem that is not easily solved.
Dr. Barry Eppley