Chin Ptosis Correction

Q: Dr. Eppley, I am interested in chin ptosis correction. I had a rhinoplastymin my early 20’s to correct a deviated septum and reduce a nasal hump. My surgeon suggested a chin implant to improve my profile since my nose was over projected. He added a button type chin implant intra-orally. However it did not seem to make much of a difference aesthetically and actually hardly showed at all. To be honest, in hindsight, I’m glad it didn’t because I have come to realize that I didn’t really need a chin implant anyway.

As the years progressed, I started noticing that my chin began to droop, especially when smiling. With research I learned that this is supposedly quite common with intra-oral chin procedures? More recently I had my nose and chin corrected by another surgeon. This time a young plastic surgeon seemed confident that he could correct the chin ptosis…he did not. Through some sort of “miscommunication”, after removing the button type implant which was supposedly placed in a strange upper region of my chin and on a slant, he added a larger implant with wings!! Needless to say it was not a good look but I tried to give him the benefit of the doubt and lived with it for 6 months. I finally decided to have it removed. The same surgeon performed the explant and tried once again to correct the ptosis. He failed once again- hence me reaching out to you. He also agreed that the chin implant was a mistake and that I looked much better without one. Thanks.

Also, he left me with superficial numbing on the left side of my chin- from my bottom lip down to chin. He does’t understand why this is, because he said that he clearly saw the nerves and that they weren’t cut. He thinks that perhaps scar tissue might be putting pressure on the nerve(s). He offered to correct it but I don’t have faith or trust in him anymore. I’ve been living with the numbness ever since.

In conclusion, after many google filled evenings researching chin specialists, I came across your website. I’m hoping that you could help me.

I’m worried that excising tissue might change my appearance or my smile and i’m afraid of more numbing. The ptosis is only visible by profile view. I don’t want to change my frontal appearance. Your advice and expertise would be greatly appreciated.

A: Thank you for providing your detailed history and pictures. With your degree of chin ptosis, I would have zero confidence that any intraoral approach would correct it. You have extra chin pad tissue now from two implants and their subsequent removal. (like have breast implants removed) That extra tissue is not going to be able to be lifted back up onto the chin….unless there is the support added to it by an implant. Since you do not need an implant, and never did, your only option now is a submental chin tuck. This is where the redundant chin tissue is removed from below.  This is a very effective procedure that will not cause any pulling of the lip downward, affect one’s smile nor cause additional nerve numbness. It is a different and simpler experience because the whole intraoral approach to its execution is avoided.

The sensory nerve numbness that you have occurred from the placement of the winged chin implant. Whether the numbness is the result of nerve stretch or some other injury during the surgery will never be known. But I know of no procedure that could reliably and safely return the feeling to the mental nerve distribution which is now affected.

Dr. Barry Eppley
Indianapolis, Indiana