How Can I Improve My Chin Reduction Results?

Q: Dr. Eppley, Over two years ago I had chin reduction surgery. The surgery went without a hitch; however, my results were mixed. My chin is now asymmetrical, though probably not because of bone. Right below my chin are what I call “pockets of fat” that stick out, making my chin appear asymmetrical. I don’t believe the raised skin is caused by fat—I just don’t have another word for it. I’ll provide pictures and you can judge for yourself. My goal with this message is to find out what is causing my asymmetrical chin and what actions I can take to fix the issue. Hopefully with you as my surgeon. I am hoping I don’t have to go under the knife but if that’s required then so be it. 

Picture 1: Sorry for the stupid pose. As you can see my chin sticks out at the bottom and causes an impression on one side of my chin and jaw. 

Picture 2: From this angle you’re able to view the “pockets of fat.” Rather than a flat neck the fat sticks out casting a shadow, even. Right under my chin in full view. 

Thank you for reading, doctor. 

A: Thank you for your inquiry and sending your pictures. While you did not say what type of chin reduction procedure was performed I assume by the scar under the chin it was a submental chin bone shaving procedure. While it would take an x-ray (panorex) to demonstrate that there is or is not any bony chin asymmetry, the most likely culprit is redundant soft tissue. When you reduce bone there always the need to reduce/redrape the soft tissue chin pad as well. That is the trickiest part of the procedure partly because of the need to limit the extent of the submental scar. It is not rare, even when one thinks enough soft tissue has been removed, that it becomes evident later when full soft tissue contraction occurs that there are remaining redundancies. What you most likely need is secondary submental tissue excision.

Dr. Barry Eppley

Indianapolis, Indiana