Q: Dr. Eppley, I would like to have my lower jaw length reduced and a more tapered shape (lean 40 year old male). Is this possible without ending-up with an excess of soft tissue? I believe a big difference could be made with minor over-all length reduction, but especially a tapering of the front at the chin where my jaw is currently just a broad, rounded mass. I would also like to have otoplasty.
A: It would be helpful to see some pictures of your face for a more definitive assessment. But your concern about potential soft tissue excess is always relevant when losing some bony support. Whether that would actually be a real problem depends on three factors; 1) how much bony, 2) the technique used for the bone reduction and 3) whether soft tissue resuspension is employed. (for the chin) But in looking at your pictures, I believe you are right on the money in regards to what you need. This could be achieved by an intraoral vertical reduction genioplasty (7mms) and lateral chin tubercle ostectomies done concurrently to reduce the vertical height of the chin and make it less square. An otoplasty could be done at the same time. I have attached a predicted image of what I envision the result to be from these procedures. Lastly, I see no concerns about loose skin after this procedure as muscle and soft tissue tightening would be done at the same time as closure of the intraoral incision.
Dr. Barry Eppley