How Can I Fix My Sagging Chin Tissue After An Intraoral Chin Reduction Procedure?
Q: Dr. Eppley, I for two years I have been looking for a solution to my problem. I had a genioplasty (periosteal detachment of the mandible with milling of the chin bone relief with the pineapple ball). Since then, my chin is hyperdynamic (spasms all day long) and all the chin tissue is falling (including the mentalis muscle). It is very annoying and my chin is very long like a witch at rest and even more when I laugh. You can see my incivilities and I have to force my mouth shut. Here in France, the problem is little known. I have read your articles, you are an expert in this matter. Can my chin problem be totally corrected? I’m talking about aesthetically because my face is disfigured because of this witch’s chin and medically because I can’t even close my mouth and the spasms make me tired.
The first picture is me before genioplasty. Is it possible to get back the exact same chin I had before the surgery? Can surgery solve all my problems both aesthetically and functionally? Or is it complicated?… What do I have to do to remove the mentalis and the submental skin? I would like to get back the exact same chin I had before.
A: This is exactly what I would expect to happen from a poorly thought out chin reduction procedure. When you detach the soft tissue and reduce the bone support this creates the problem of soft tissue chin pad excess. The chin pad has virtually no ability to contract when the bone support is removed leading to chin ptosis, either at rest, smiling or both. As a result, the redundant soft tissues ball up and the mentalis muscle never works quite the same because it has lost its original working length.
Improvement is possible and the technique to do so depends on whether the chin bone is desired to be restored or not. If so I can consider an intraoral sliding genioplasty with muscle/chin pad resuspension. If not then a submental excision/tuck is needed.
Dr. Barry Eppley