How Can I Fix My Tight Scarred Down Chin After A Large Intraoral Chin Reduction?
Q: Dr. Eppley,I’m hoping you could help me here. I had a reduction genioplasty 8mm bone shave. The outcome looks awful but I’m now suffering with tightness in the chin. I feel like I’m unable to move my chin. It feels tight where the muscle has been stitched. My intraoral incision has scarred to high up on my tooth line. My mouth movements look funny and I also can’t retract my lower lip downwards. Not being able to show any of my bottom teeth this also has an effect on my speech and movements. I’m so scared to have another procedure because of the amount of scarring I have. I have attached some pictures for you to see. My chin also looks lumpy.
A:I believe we have had this discussion previously but to review it again. A large shave down intraoral bony reduction genioplasty is never a good idea and is prone to a lot of potential problems…many of which you have. Once such a large amount of bony support is removed where does all the enveloping soft tissues go? Unfortunately it does not just shrink down and adapt around the reduced bony chin. Rather it turns into a ball of contracted muscle and scar tissue which is both stiff and immobile. The contour also become irregular due to the soft tissue contracture. I see no other effective option for improvement but to release the scarred soft tissue chin pad and put back some of the bony support lost. (aka sliding genioplasty) Whether the movement should be a partial or complete restoration of the lost bony projection can be debated.
Dr. Barry Eppley