Can My Chin Irregularities Be Fixed and My Chin Made Smaller as Well?
Q: Dr. Eppley, I’ve had jaw realignment surgery, along with a genioplasty (burring) followed by a revision genioplasty 2.5 years ago. The initial surgery was done because my jaw grew longer on one side. The initial jaw surgery/genioplasty did a great deal to correct the asymmetry, but I still had some nagging asymmetry especially when viewed from below, and I was also interested in a slight narrowing. Following the revision genioplasty (also burring) I have quite a bit of dimpling in the chin and it did nothing to narrow the chin. First, I’m curious for a professional opinion if my desired look was ever actually achievable or realistic (I’ve attached photos). Second, I’m wondering if there’s anything that can be done to improve the dimpling/ scar tissue to gain a better contour. I would like to avoid filler or anything that would make the chin longer/ wider.
A: Thank you for your inquiry. If I understand your history correctly you have had two bony genioplasty surgeries both of which used a burring technique. It was the second chin surgery that has created the chin indentations/dimpling you have now. I am assuming that both burring efforts were done from an intraoral approach since I don’t see a submental scar.
In answer to your secondary chin reshaping questions:
1) Your initial desired chin shape results may have been possible but never with a primary burring technique done from an intraoral approach. That technique completely degloves the soft tissue of the chin, reduces bony support and then often creates chin irregularities due to the mismatch between the same volume soft tissue and the reduced bone size which it envelopes.
2) The better initial approach would have been either intraoral t-shaped osteotomies or a submental shaving technique with some soft tissue reduction. But that is irrelevant now.
3) The more relevant question is what can be done for any further improvement. This is a primary soft tissue problem which can only be done from a submental soft tissue excision/tuck up procedure. How much improvement could be obtained can not be predicted beforehand. When such irregularities occur in the soft tissue chin pad they can be very difficult if not impossible to eradicate.
4) I would agree with you that adding fillers into the indentations will make your chin bigger which is the antithesis of what you are trying to achieve.
Dr. Barry Eppley