Am I A Good Candidate For Mentalis Resuspension?

Q: Dr. Eppley, I am interested in mentalis muscle/chin pad resuspension. I’m highly motivated, but the operation must improve my aesthetic and medical condition, not make it worse of course.Since the primary genioplasty, I’ve had enormous discomfort in speaking, with this feeling that the muscle is preventing me from going back up, which borders on the internal scar of the vestibule. The mentalis muscle is very active and doesn’t seem to communicate with the lower lip despite all its efforts 🙂 the vestibule in my case is very deep with a large internal scar that seems to create a border and separate the muscle from the lower lip area, which is far too low. On the frontal X-ray, you’ll see that there’s some kind of wire (and maybe plates and screws or not ?) preventing my muscle from rising?

IN PROFILE YOU can see the chin (added or not) and the material that can support the higher attachment of the muscle?

I understand that there is a combination of techniques: muscle suspension, chin support (yes?) and a shortening vestibuloplasty? (shortening the depth of the vestibule by sewing the two edges of the vestibule mucosa higher together to support a higher lower lip and prevent relapse).

If the doctor sees a lasting solution I am available.

A:Thank you for sending your x-ray which shows a single wire ligature, which an old-fashioned method for chin osteotomy fixation, can be effective based on the amount of chin bone movement. That being said the wire ligature it is not impeding muscle movement although it would be removed in mentalis/chin pad resuspension surgery. As you have correctly noted mentalis resuspension is more then just a single technique and involves multiple combined tissue approaches as you have mentioned.

While there are no other methods to improve your problem, as I have previously pointed out, mentalis and chin pad resuspension is a challenging procedure with variable long term outcomes. There are no guarantees in any surgery and mentalis resuspension is no different. The question is not whether it will make anything worse, which it will not, but how much improvement in the long-term can it achieve.

Dr. Barry Eppley

World-Renowned Plastic Surgeon