Chin Ptosis Repair

Q: Dr. Eppley, I am interested in chin ptosis repair. I had a surgery for chin implant one year ago. It was a silicone implant and surgery was done from inside my mouth. I also had a dimple in my chin which I asked the doctor to get rid of. He put the implant, but it was too big for me so the wound from inside my mouth wouldn’t heal. I had to get the implant removed just after two  weeks of getting it done. He said I would have to wait six months until I could put a new one in. Somehow the dimple i had in my chin is not there anymore and my chin looks completely different from what it was before. It has been a year and a half now and I’m not happy with it. But during this year and a half, it seems that it got uglier from what it was before from when i just got it removed.

I only had the implant for two or three weeks as the wound wouldn’t close. The doctor tried to stitch it back a couple times but the stitches wouldn’t stay and I could literally see the implant when I opened my mouth. I luckily didn’t get any infection. He told me that I could get a chin implant again in six months but obviously I never went back to him since then my chin keeps getting a worse look, I don’t know what to do.

A: Thank you for sending your picture. What you have is true chin ptosis as you initially suggested. You have four chin ptosis repair options at this point:

1) Do an intraoral chin ptosis repair. This is usually marginally successful because you have both detached and some stretched out chin tissues.

2) Do a submental chin ptosis repair. This is done from below by removing the soft tissue overhang. It is very successful because it removes loose tissue but does so at the expense of a submental skin scar.

3) Do a combined intraoral ptosis repair with a small chin implant. This is more successful than #1 because it adds support low on the chin bone for the resuspended chin soft tissues.

4) Do a sliding genioplasty. This is like #3 but uses your own bone and not an implant to create the support for the uplifted soft tissues. This probably offers the most successful outcome of all options listed but is the most ‘invasive’.

The reality is that it will be difficult to go ‘back home’…meaning going back to where you started before the chin implant was placed. That is probably a complete impossibility. Options #3 and #4 offer the combination of creating a chin augmentation effect that you were originally seeking and also solving the chin ptosis problem.

Dr. Barry Eppley
Indianapolis, Indiana