Mentalis Muscle Resuspension

Q: Dr. Eppley, I read on the internet that you specialize in mentalis muscle resuspension surgery in case of lower lip ptosis. I have developed ptosis as a result of revision jaw surgery and genioplasty and the result is that I’m showing approximately 4mm more of my lower incisors that I did before. In addition, my chin goes in a weird shape when I’m trying to close my lips (“witches chin deformity”) even though I do not have a deficient chin. (See attached photos) During the first surgery my doctor overdid the forward movement of the genioplasty and during the second surgery, the second surgeon burred the bone of the chine in order to reduce the forward projection again (he was not able to do a reduction genioplasty because the first genioplasty was too assymetric). This is what caused the problem. 

I wondered what the approximate success rate of ptosis correction surgery is for cases such as mine. In how many % of the cases is such surgery successful? How many mm elevation of the lower lip can be achieved on average? Many thanks in advance.

A: Thank you for your inquiry. Correction of lower lip sag and a mentalis muscle deformity of the chin pad are very difficult problems to improve that often have low success rates. It was not very prudent of your surgeon to burr the chin bone down after the sliding geniplasty as this has caused a loss of bony support and soft tissue collapse. This is why you have chin pad deformity when trying to close your lips. The lack of chin projection and the lower lip sag are intimately related.

Dr. Barry Eppley

Indianapolis, Indiana