Can My Tight Lower Lip Be Improved After A Sliding Genioplasty?

Q: Dr. Eppley, I have a question regarding revising a sliding genioplasty. About a year ago, I had a sliding genioplasty that moved my chin forward by 8mm. The recovery has been uneventful, and all numbness and swelling is gone. One problem, however, is that my upper chin/below my lower lip feels pretty tight. It takes a bit of effort to close my mouth completely and sometimes bothers my speech.  Is there any way to fix that?

A: What you have is tightness of the mentalis muscle and shortening of the anterior mandibular vestibule. Because a sliding genioplasty is done through an intraoral approach and must take down the superior mentalis muscle attachments, the combination of stretching them (from the advancement) and scarring will cause the muscles to be short or adhered. This can likely be improved through a mentalis muscle release and resuspension with a V-Y mucosal inner lip advancement. I have seen this problem numerous times and successful improved it through this soft tissue repositioning approach.

Dr. Barry Eppley

Indianapolis, Indiana