Chin Reduction for Hyperdynamic Ptosis

Q: Dr. Eppley, I am looking to get a chin reduction, I have lots of soft tissue and bone that sticks forwards when I smile. However when I don’t smile my side profile looks slightly weak due to the way the soft tissue sits. I also have a small overbite.

My face structure becomes very witch like when I smile. I am hoping to achieve a more symmetrical v-line chin, I quite like the shape of my chin from the front but I would like to remove the part that sticks forwards. 

I have a very petite face and don’t really want to loose much vertical length, it’s more the way it sticks forwards from the side that bothers me. 

My face is also asymmetrical, I have TMJ in the left side of my jaw, this side of my face is more rounder & wider than the left side of my face. 

I have attached lots of photos to give you a good idea of how my chin looks from different angles. Would a simple chin reduction be able to fix my problem? I would like to avoid implants and adjust the bone and soft tissue if possible. However I worry that reducing the bone would result in a weak side profile when not smiling as it only sticks forwards when I smile. 

I feel like my chin ruins my whole face and I would be much prettier if I could fix it. 

A: Thank you for your inquiry, detailing your objectives and sending your pictures. With a hyperdynamic chin protrusion but a weaker or more normal chin shape at rest, that makes can reduction more aesthetically precarious. Chin reduction surgery reduces soft tissue, bone or both but the most effective chin reductions remove both bone and soft tissue. But no matter what tissues are removed it will have different effects from smiling to non-smiling. If the reduction improves how it looks when smiling there is the risk it may adversely affect how it looks when not smiling. (as you have astutely mentioned) Thus it is not likely possible that any chin reduction procedure will produce the desired chin shape from any angle regardless of whether one is smiling or not. That is not a completely realistic and achievable aesthetic goal.

In hyperdynamic chin protrusions like yours some horizontal bone and width reshaping (not vertical length reduction) with a submental soft tissue excision/tuck is the likely effective approach.

Dr. Barry Eppley

Indianapolis, Indiana