Chin Ptosis

Q: Dr. Eppley, I have a chin ptosis problem. It started when I was 15 years old and I had a very long chin as my lower jaw was pushed forward and my bottom teeth were pushed in front of my upper teeth. The operation was done from inside of the mouth.The operation was:

1) removed of the bone of the chin

2) moved forward the upper jaw  in order to get right biting point 

As the bone has been removed from the chin, the soft tissue of the chin started to hang. And since then I have never been the same girl.  The second operation I have had when I was 21 years old did not turn out well either. This time the Dr advised me to get a traditional liposuction directly on my chin to which I agreed. This did not help.

So now I’m still not where I wanted to be and this time I’ve decided to get advice from you

Thanks to the Dr’s who ruined my confidence as I can’t smile, laugh or even talk properly because everything below my nose has been destroyed.

Please let me know your thoughts of the pictures attached and thank you very much for your help.

A: Thank you for your detailed history and sending your pictures. You have two distinct and related chin problems. First there is significant chin ptosis (soft tissue overhang) at rest which worsens on smiling. Secondly you have a central lower lip sag which fortunately only appears with smiling and not at rest.  While pushing up on the overhanging chin pad corrects both problems, that effect can not be created surgically through intraoral mentalis muscle resuspension. While that sounds theoretically appealing, it just is not that effective at making that much of a ‘chin lift’ . The alternative approach is a submental excision of the chin pad overhang and tuck. That is a definitive solution for the chin tissue overhang. It may be best to leave the lower lip sag alone or combine it with an intraoral muscle resuspension at the same time just to see if any improvement in it can be obtained.

Dr. Barry Eppley

Indianapolis, Indiana