Q: Dr. Eppley, I appreciate that you take the time to educate the public on plastic surgery, and I want to thank you for that. I’m planning on going to you this summer for temporal width reduction, cheekbone reduction, and chin/jaw reduction as my face is wide.
I had an intraoral chin reduction which I immediately regretted from a less experienced surgeon. He did a sliding genioplasty to move the chin backwards to reduce the horizontal projection, and also did some intraoral burring on the sides to reduce the width. The end result is that I still had a very wide chin. It was a bit less square, but still very wide. I was also left with drooping under my chin.
I had a revision with another surgeon in December in which he did a submental tuck-up which seems to have fixed the droopy chin problem, and he also did submental burring to reduce the width. It did reduce the width, but not as much as I would have liked.
I just want a more feminine, tapered lower face but my chin still looks a bit wide and full. I asked you in a previous question about if an intraoral wedge narrowing approach would produced a more significant narrowing effect than a submental approach, and you said it shouldn’t matter. So I’m wondering:
1) For chin narrowing, are burring-only approaches not as effective as tubercle ostectomy approaches?
2) What is the ultimate limitation of how much the chin can be narrowed? Is it because of the mental nerve? Since the mental nerve is located on either side, could an intraoral wedge reduction approach allow for more width reduction because it’s between the mental nerves?
Thank you so much!
A: In answer to your chin reduction questions:
1) In reality the submental shaving reduction technique is the most effective technique as it provides the best visual access and can take the bone removal back far along the jawline. The intraoral wedge reduction technique is more limited because it is a superior approach that is limited by the location of the mental nerves.
2) Chin reduction reshaping is done below the level of the mental nerve so there is no restriction in the amount of bone reduction that can be done. The limits are what the soft tissue can allow without resulting in ptosis or sagging.
Dr. Barry Eppley