How Can I Improve The Lower Lip Tightness After A Sliding Genioplasty?

Q: Dr. Eppley, I got a sliding genioplasty last year and my bottom lip is still tight. The area under my lip feels stiff and or like its being pulled. My lips close fine, although my bottom lip appears a little smaller now. I have read a lot of your posts and it seems like the intraoral release with fat filler is something that you often  recommend for this. I spoke to my surgeon about it and I was told that a V-Y procedure is something that she offers. Is that similar to what you do? Is it as effective? I am worried that this might make it worse. thank you!

A:Tissue tightness indicates scar contracture which ultimately means there is a tissue deficiency. Tissue deficiency issues are improved by a release, creation of a new dead space (tissue expansion) and filled in with a tissue replacement. (aka fat graft) In other words you solve tissue tightness by adding more tissue, not by simply moving what is already deficient around. (e.g., V – Y advancement) You have justifiable concern that a tissue rearrangement approach would not make it better and may make it worse. (more scar)

Dr. Barry Eppley

World-Renowned Plastic Surgeon