Q : I had a sliding genioplasty surgery with bone graft on my jaw angle on the 17th of august, before the surgery when i smile my chin tissue protudes downward (chin ptosis) the oral maxilofacila surgeon told me he can fix it during the sliding genioplasty surgery, its been 3 weeks now, and when i smile my chin tissue still protudes downward, i told him about it and he said my mental labial fold has not heal completely thats why it protrudes downward, i think is cos he didnt move my chin forward enough. i wan to send photo to you so you can see what i mean, i really want to get this fixed asap.
A: Generally, a sliding genioplasty will pick up loose chin tissues as it comes forward. Thus correcting a pre-existing chin ptosis. It is not so much that the bone is advanced, but the mentalis muscle and the chin skin are pulled back over a longer bone surface. This is essentially the reverse of what happens when the bony chin is set back (not a good idea) as there is too much chin soft tissue that has less bone surface to be suspended and it will then droop.
Why your chin ptosis did not at least get some correction with the advanced bony chin is not clear. The one possibility is that the mentalis muscle was not put back or resuspended as well as it could be, thus negating the effects of better bony support. This is easily corrected at this early point after surgery as little actual tissue healing has occurred. More time and having the swelling go down further will not likely show an improvement. I would recommend re-entry and better muscle suspension.
Dr. Barry Eppley