Would I Benefit From Mentalis Muscle Resuspension?

Q: Dr. Eppley, Two years ago I had an orthognathic surgery with a sliding genioplasty. One month later a second bimaxillary surgery was done to correct the errors of the first. At this surgery the chin was brought back to its original position and the mentalis muscle. Six months later I underwent a third bimaxillary surgery at which a resuspension of the mentalis muscle was attempted but I believe that due to the huge swelling it was not reattached at the right height.

From pictures and video you can see the lip incompetence and the descent of the tissues which creates a strange projection of the chin and a descent of the upper and lower lip. What can be done to resolve the situation?

A: Thank you for your inquiry and detailing your extensive bimaxilary and chin surgery history. Between the three chin surgeries and the expansion and secondary set back of the bony chin, this strikes me as more of a tissue excess issue not a lack of adequate soft tissue suspension. Having had a failed mentalis muscle suspension x 2, this does not speak well for what any further suspension procedure would do. Mentalis muscle suspension works best when there is a true chin ptosis with visible sagging of the chin pad which can be seen to hang off of the chin. Your chin, however, looks more like an overall excess of chin tissue for the bone not a true ptosis. Between the trauma and soft tissue degloving from the three bimaxillary procedures as well as that of the chin surgeries, I think you have an overall chin pad soft tissue excess and laxity for which a suspension procedure is not going to solve.

Dr. Barry Eppley

Indianapolis, Indiana