How Can I Fix My Lower Lip Incompetence After A Sliding Genioplasty?

Q: Dr. Eppley, I had a sliding genioplasty 7 months ago. Unfortunately, ever since then I have been facing lip imcompetence, open lips at rest and feel like I have to pull a muscle everytime I force my lips to close. Additionally from my observation the surgery has left me with a longer chin, longer philtrum and a different lip shape. I wondered if this would get better if the titanium plate was removed. My surgeon has dismissed my concerns and seemed clueless when I mentioned mentalis muscle resuspension. He only injected a steroid injection on my chin saying that this was scar tissue, unfortunately that didnt help with my problem at all. 

A:Such lower lip incompetencies after a sliding genioplasty can be very hard to correct. But what I can say with good prediction is that removing the plate and screws alone will provide no improvement as this is a soft tissue sag issue. In the execution of an intraoral mentalis muscle resuspension procedure the hardware would be removed as a matter of convenience as well as getting it out of the way for the new suspension point. Having performed many hundreds of mentalis resuspension procedures over the years I view their success rate as about 50%. Judging the real success of such a procedure is not what it is like in the first few weeks but what it is like 3 to 4 months later.

Dr. Barry Eppley

World-Renowned Plastic Surgeon