Submental Chin Reduction for Hyperdynamic Chin Ptosis

Q: Dr. Eppley, I just sent a request for the “Predict my face” on your website. I am scheduled for a submental chin reduction on January 15th. It’s obvious when I’m smiling that my chin needs reducing. This is what motivated me to pursue this procedure. However, when playing around with photo morphs, I came to realize that when I’m not smiling, the chin seems to be in the right place (very slightly protruded). I have a unique profile view because my lower jaw may be slightly receded (although my bite is good, there is a slight overbite). When I reduce my chin in the non-smiling photos, it doesn’t take long before I look like I have a receding chin.

I have attached a video of me progressing from not-smiling to smiling. About how much are you thinking needs to be reduced? I believe that the procedure will still benefit my profile, do you agree?

On another note, I have attempted to get the cone beam x-ray, but places around here will only let me use their machine if I am patient of theirs. I’m not planning on getting it done unless you think it will be helpful in determining the amount to be removed.

A: In answer to your questions:

1) In hyperdynamic chin ptosis , the chin position at rest is often normal. That always poses a dilemma because surgery is done in a static position (at rest) for the treatment of largely a dynamic problem. (in motion) The key is to not overdo the procedure and treat it like it is a large protruding chin at rest.

2) While at rest I would not consider your chin overly protrusive it is still a strong chin in profile that a few millimeters of projection loss would not cause it to become recessive. 

3) The removal of 2mms of bone is merely to allow the soft issue resection to be tucked in to reduce the dynamic protrusion of the soft tissue chin pad. 

4) A preoperative x-ray is not needed since the procedure is not largely based on bone resection as so indicated in #3 above.

Dr. Barry Eppley

Indianapolis, Indiana