Can The Tightness Of The Chin After A Sliding Genioplasty Be Fixed?

Q: Dr. Eppley, I am a young man who is three months out from a genioplasty (8mm advancement) and suffering with severe lip and upper chin tightness / tissue tugging when I raise my lower lip or move it sideways. It impacts speech and any slight lip movement. 

The genioplasty was a revision after two months because the original operation had left significant asymmetry. So there have already been two operations in quick succession. 

As well as significant tightness and discomfort, I have a high-riding and overactive mentalis muscle and rely on this muscle to close my lips at rest due to lip incompetence. When contracted the muscle presents a noticeable bulge and introduces the tight / tugging sensation.

When at rest my lower lip sags and exposes my lower incisors. 

I have read your literature on scar contracture of the soft tissues into the void created by the chin step and believe I am suffering with this.

I wondered if you could recommend any specialist in the UK who might be able to help with my issues? As I live in the UK this might make more sense rather than making trips to USA. 

I am not sure my current surgeon is familiar with this complication and wish to explore options to try and improve the current feeling. 

Is there value in treating this sooner rather than later? Steroid injections, fat injections, for example, as first solution?

Appreciate any advice you can offer in the short term ahead of our consultation. 

A:Thank you for your inquiry and detailing your concerns. I would not know who, if anyone, in the UK would perform this procedure to treat this type of postop genioplasty problem. But any non-surgical treatment by injection, regardless of the agent, would not be harmful. It may or may not provide some relief but at the least it will not make anything worse. There is no urgency to jump right in and do anything immediately as the symptoms you have will not get worse.

Dr. Barry Eppley

Indianapolis, Indiana