Sliding Genioplasty Revision
Q: Dr. Eppley, I am interested in sliding genioplasty revision surgery. I had a sliding genioplasty done five years ago for aesthetic chin contouring. A subsequent fat injection was done over the lower margin of chin for further chin contouring a year later. Afterward, I have functional disorder of the lower lip and chin so I took my doctor’s advice on removal of miniplate and screw via intraoral incision. The disorders of the lower lip and speech persisted. So I took my doctor’s advice on steroid injection for scar adhesion release which provided no improvement and made it even worse.
Now I feel tight while talking and eating. There is a line between my lower lip and chin. Muscle below the line will rise and stick to the line while talking, therefore I have difficulty talking smoothly. Some doctors said since I have had two surgeries via intraoral incision, there may be something wrong with my mentalis muscle and scar adhesion. Please diagnose my symptom. If there is something wrong with mentalis muscle or possible scar adhesion or else, please help me, because you are a master in this field. I need your help. In fact, I don’t know what to do next. I hope to talk smoothly. I pray to God for it. Hope you can help me. Hope to receive your e-mail as soon as possible.
A: While I have not seen any pictures of your chin, your story is not unfamiliar to me. This sounds like scar adhesion/contracture in the chin soft tissues. This is particularly evident in the tight and deep labiodental fold. This is a problem of both and now lack of supple tissues in this area. In my experience treating this problem, I advocate for your sliding geniplasty revision releasing the intraoral adhesions over the chin bone and muscle and placing a dermal fat graft. This now only releases the tight tissues but brings in new and unscarred tissue to make the tissues more supple/soft.
Dr. Barry Eppley