Tightness after Sliding Genioplasty
Q: Dr. Eppley, I had a sliding genioplasty several months ago and have muscle strain in my chin and my lower lip no longer functions the way it use to. My lower lip will not meet my upper lip without force and ends up tucking up under my upper lip when I chew, almost disappearing. My chin bunches up when I close my mouth and now I’m stuck with this open mouth expression all the time. My lower lip has also thinned and falls well below my lower teeth as if it’s being pulled down. My surgeon told me he projected my chin out by 4mm but not sure on the hight. I’ve read message boards of patients with the exact issues as me and say time has not corrected this. Is there anything that can be done to correct this Dr. Eppley? I asked my Surgeon to reverse or adjust my procedure but he will not. I am very distraught and not sure what to do.
A: To have such a cascade of perioral symptoms from a small 4mm horizontal advancement sliding genioplasty is very uncommon in my experience and is more likely with much larger bony chin movements. But that issue aside the question is why you have such symptoms…it is because of the bone movement or does it have to more with the soft tissue closure/adaptation to the new chin position? To give an informed answer it would be helpful to see before and after pictures of your face and any after surgery x-rays if your surgeon obtained them.
But in refractory cases like yours where the symptoms did not improve with time, a reversal procedure would be the most logical approach to improving your current symptoms.
Dr. Barry Eppley