Sliding Genioplasty Reversal

Q: Dr. Eppley, I’m seriously considering reversing my sliding genioplasty. 

Here are two questions:

1) I read your post about genioplasty reversal on Real-Self. You said: “resuspend/tighten the mentalis muscles at the same time so you do not get a soft tissue ptosis (witch’s chin) as a result of the loss of bony projection/support”

In my case, do you think we would need to resuspend the mentalis muscles? (I’m almost one year from the original genioplasty and the movement was 4mm forward and 2 downward) Is it a technique used in every genioplasty case or only in reversal ones?

2) Is that possible for the muscle and tissue to go back to where they were before the surgery?(not 100%, but mostly) I’m worried about skin sagging and facial deformity. (I’m 32 and my skin is good).

Thank you so much!

A: In answer to you sliding genioplasty reversal questions:

1) By definition every closure of a sliding genioplasty, regardless of the direction of movement, entails resuspending the mentalis muscle since you have to release it during incisional access to do the procedure. How tightly you may reattach the muscle is what varies on an individual patient basis.

2) It is safe to assume in the reversal of any enlargement procedure of the body, albeit a sliding genioplasty, breast implant removal or pregnancy, that the tissues will never return to what they were before the enlargement procedure. All surgery causes some irreversible changes. So the question is not whether one will return 100% to normal, as you won’t, but how close to normal would it be. Given that your original sliding genioplasty was relatively modest, your chances are better than a sliding genioplasty in which much bigger movements were done.

Dr. Barry Eppley

Indianapolis, Indiana