Q: Hello Doctor, my question is about how to correct the sagging chin after chin implant removal. I had a chin implant removed several years ago and developed initially fluid and then a ball of scar tissue. My chin hangs down now off of the bone. I know that the scar tissue can be cut out from the labiomental sulcus and chin, but how do you reposition the muscle back onto the bone? No one seems to explain that part of the procedure. How that is done is very important for me to know before I consider having the procedure.
A: In the treatment of soft tissue sag after chin implant removal, the muscle must be reattached back to the bone and in a higher position…if one is doing the surgery from an intraoral or inside the mouth approach. When the chin sagging is not that severe or one wants to avoid a submental scar, then the intraoral approach is used. Putting the muscle and soft tissues back is done using small suture anchors. These are small resorbable bone anchors into which are attached sutures. They are first placed into the bone in the desired position (below the teeth roots) and then the sutures are passed into the muscle and tied down. This is a classic orthopedic surgery approach that is commonly used when they reattach tendon and muscles to the bone around joints.
When the chin sag is more severe, it may be best to consider a submental approach and remove and tighten tissues from underneath the chin.
Dr. Barry Eppley