Q: Dr. Eppley, I had a chin implant removed and my chin muscle sags now. Because the initial surgery was fraught with infections and complications, my chin muscle was cut into four more times after the first surgery. Doctors tell me now, 4 years later, that the chances that I could have my chin muscle reattached higher, where it used to be, is slim. Since there is very little of anything left to sew into, I’ve been told that they could try and drill screws near the nerves of my bottom teeth and try to attach something that way, but this is unlikely. Is there a surgeon out there who has dealt with this same issue successfully? I am desperate to get my face back. There must be some way to reattach my chin muscle!! Help, please!
A: Reattachment of the mentalis muscle is very possible. The key is to have a stable method and non-injurious place to attach the muscle/scar. This is best done with micro-suture anchors that are designed to be very small (1.5mms) and can be placed over (in between) the roots of the lower anterior incisor teeth. I have found this technique to be successful, regardless of how many times the mentalis muscle has been re-entered.
Despite re-attaching the mentalis muscle, complete improvement of the sagging chin pad may not still be obtained. The implant may have created some extra chin tissues through expansion that a combined submental tuck-up may be needed as well to get a tight redraping of all of the soft tissues over the convex chin bone. Whether this approach to you revisional chin surgery is needed would require photogtraphs and an examination to determine.
Dr. Barry Eppley