Q: Dr. Eppley, I am interested in getting a chin reduction for the vertical height of my chin as well as making the projection smaller when you look at my profile. I also have a chin dimple right in the center of my chin that I want removed and smoothed out. I am a 23 year old female. What can be done for me to achieve this? Also, I worry about loose skin after the reduction, what can be done to avoid that? I have a very tight jawline and I do not want to lose the definition.
A: Chin reduction can only be done only one of two ways from an incisional standpoint. Either it is done from an intraoral (inside the mouth) or a submental (under the chin) approach. Which is best depends on the dimensions of the bony reduction and how much, if any, excess chin pad tissues may result. I only see a frontal view picture attached and I need a side view picture (non-smiling) to determine what the horizontal reduction needs are if any. Most effective chin reductions are done from a submental approach to address this soft tissue concern.
The chin dimple is best treated simultaneously with fat injections to try and reduce/eliminate it.
Dr. Barry Eppley
Q: Dr. Eppley, I have a mild chin cleft that I would like corrected. I have attached a picture so you can have a better understanding. It drives me nuts when I smile as it is so visible particularly in pictures.
A: By your picture what you have is a chin dimple not a chin cleft. That may seem like a semantic difference but anatomically there are somewhat different entities and are treated a little differently. A chin dimple that presents itself when you animate (smile) represents a defect in the mentalis muscle that covers the chin. Lacking fat underneath it and a defect in the muscle, the skin is pulled inward acting like an adhesion to the underlying tissues. Conceptually, volume needs to be added under to dimple to push it outward. This can be done by a number of ways but the simplest method is to place some injectable fillers (e.g., Juvederm) underneath the chin dimple. While this simple office treatment will not be permanent it will last 6 to 9 months and will answer the question whether the ultimate placement of fat injections would be the best long-term treatment of your chin dimple correction.
Dr. Barry Eppley
Q: Dr. Eppley, I just had my cleft chin reduction surgery on this past Thursday October 11th. I’m having a difficult time opening my mouth and am wondering if this is normal after this kind of procedure. It feels like there is some kind of resistance on the left side of my jaw (which is the same side of my mouth where fat was taken from) whenever I try to open my mouth past an inch or so. It doesn’t hurt, it just pulls.
A: What you are experiencing is perfectly normal. For your chin cleft correction a small buccal fat graft was harvested through a small incision high in the maxillary vestibule. This requires going through the buccinator muscle and then closing the incision with a few dissolveable sutures. This will definitely make in the first few weeks a sensation of tightness when opening your mouth widely. That is because the intraoral mucosa and buccinator muscle stretch when opening and now have a little constriction. This is a temporary minor problem which will be self-solving in a few weeks.
Dr. Barry Eppley