Q: Dr. Eppley, I am seeking a witch’s chin correction. My chin sags down like a witch’s chin after my chin reduction ten years ago. Also I would like to remove the neck fat because my jaw is narrow and gets lost in my neck. I would like my profile to be more balanced, so I am hoping that Smart lipo will fix this. The attached x-ray was requested by a surgeon who does facial feminization, even though at this point, I only wanted my jawline and chin corrected. My chin and jaw are off balance, but I don’t want to go through any bone surgery if I don’t have to. My chin midline is slightly off per the surgeon who requested this x-ray.
A: Because you have a witch’s chin deformity from an intraoral chin reduction, your x-rays shows exactly what one would have predicted. You can see the chin reduction which was done which left behind the large chin soft tissue pad which is now unsupported. Your x-rays shows why an intraoral chin reduction does not achieve the desired effect and creates the witch’s chin deformity that you have. This type of chin reduction is ill-conceived and is not anatomically correct. A witch’c chin correction is not going to occur by any form of liposuction. Rather you need tissue resection through a submental incisional approach to make the chin pad tissue match the lesser amount of chin bone support that you now have.
Dr. Barry Eppley