How Can I Correct My Droopy Chin After Two Bony Genioplasty Procedures?

Q: Dr. Eppley, I need a Chin ptosis correction Hello I had a chin medpor implant ten years ago. i decided to remove the implant with maxillofacial surgeon and this was the report. (Clinical and radiographic exam revealed : Poorly placed medpor chin implant. Based on that the patient underwent the following surgery under general anesthesia : -Removal of old medpor implant – Genioplasty advancement of 6mm. Intraoperatively it was found that the old medpor implant caused severe bone resorption in the area because it was not fixed in place. Following the surgery the patient was not happy with the final result) After that i went to another maxillofacial surgeon and he decided to make another surgery and this was his report: (Under GA nasoendotracheal tube previous chin plate exposed and found to be only 2mm advancement done in the previous surgery plate removed reduction Genioplasty 2mm anterior and 0 posterior of chin fixation with two L shape plate size 1.5mm in the thickness with 4 screws 6 mm in length). After 6 months i go back to him i was not satisfied with the result as you can see in the pictures drooping chin and drooping of the soft tissues in the chin pad when i smile. The doctor said i have two things First fibrosis and increased chin soft tissues. After the chin muscle droop it caused sagging of the tissues that the reason of the shape you have from the side view. I do not want just a surgical correction i also want an aesthetic shape if it’s possible .

A: Thank you for your inquiry, detailing your history and sending your pictures. You have chin pad ptosis but without lower lip incompetence. Presuming you are happy with your current chin projection the correct procedure would be a submental resection of the low hanging soft tissue chin pad. This would be the most effective procedure for eliminating the soft tissue chin pad overhang albeit with a fine line scar under the chin. If you are not happy with your current chin projection then I would need to see some x-rays to look at what has been done to your chin from the prior bony genioplasty procedures.

Dr. Barry Eppley

Indianapolis, Indiana