Q: Dr. Eppley, I am investigating the possibility of narrowing my wide chin. I am 55 years old and have noticed the characteristic age-related lower face widening as a result of the increasing tissue laxity. While I am planning a facelift within the next year or so, I think a narrower chin will look nicer, more feminine and less bony once I have the jowls tightened. I have the following questions.
1) Am I a candidate for the submental approach and would this involve just burring down the sides of my chin? (I think my profile is fine and don’t need an implant)
2) Wait time after chin reduction before a lower facelift could be done.
3) Likelihood of complete resolution of any numbness? And additional risks due to my age?
A: 1) I would have to see pictures to determine your candidacy for the procedure. But usually the submental approach is best due to better access to the bone with a minimal risk of any nerve injury. If side chin reduction is only needed, an ostectomy with a saw for narrowing would be the technique used.
2) If one has to stage it, the chin reduction would be done first with a minimum three month delay before the lower facelift. The two procedures could also be combined.
3) When done from below, the mental nerve is well visualized so permanent injury to it is unlikely. Simple stretching and elevation of the soft tissues off of the bone will likely cause some mild temporary numbness or none at all. Other than the age-independent risk of mental nerve neuropraxia, I can foresee no other significant risks other than achieving the desired chin shape.
Dr. Barry Eppley