Chin Ptosis

[Serra]

This is a complication I'm struggling with after SG. I cannot find one instance where this was corrected. This thread will be a collection of information on the subject.

[Serra]

J Oral Maxillofac Surg. 2001 May;59(5):510-6; discussion 517.

The effect of precise reattachment of the mentalis muscle on the soft tissue response to genioplasty.

Chaushu G1, Blinder D, Taicher S, Chaushu S.



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Abstract

PURPOSE:

This study compares vertical and horizontal profile changes of the lower lip and chin after genioplasty with or without precise reattachment of the mentalis muscle.

PATIENTS AND METHODS:

Ten patients in whom the mentalis muscle was isolated, identified, marked, and precisely reapproximated comprised the study group. Eleven patients treated without precise reattachment of the mentalis comprised the control group. Preoperative (3 to 6 days before the surgery) and postoperative (6 months after surgery) lateral cephalograms were analyzed to assess the horizontal and vertical soft tissue changes of the lower lip and chin area.

RESULTS:

All the significant changes in the present study were noted in the vertical parameters. In most of the study group, the length of the lower lip was either maintained or increased. In the control group, the lower lip length was either preserved or decreased. The mean vertical difference between the 2 groups was nearly 6 mm. Consequently, the study group displayed the same or less of the lower incisors postsurgery compared with the original presurgery exposure in the rest position. The opposite was true for the control group, in which the exposure of the lower incisor crowns at rest increased. Similar changes were noticed in the distance from the vermilion to the reference plane. The vertical position of the soft tissue supramentale remained unchanged in the study group, whereas in the control group the soft tissue supramentale was located in an inferior position (mean = 2.14 mm). The clinical expression of this phenomena is chin ptosis.

CONCLUSIONS:

Precise reattachment of the mentalis muscle during an intraoral surgical approach produces a superior result.

Copyright 2001 American Association of Oral and Maxillofacial Surgeons

http://www.ncbi.nlm.nih.gov/pubmed/11326372

[Serra]

J Craniofac Surg. 2013;24(5):e445-58. doi: 10.1097/SCS.0b013e31829026af.

The extent of chin ptosis and lower incisor exposure changes following the osseous genioplasties.

Soydan SS1, Cubuk S, Pektas ZO, Uckan S.



Author information



Abstract

The incision and dissection of the mentalis muscles are inevitable to access the osteotomy line during genial surgery. As the mentalis muscles elevate the central lower lip and support the lip vertically, inadvertent scarring or lengthening of these muscles may lead to lip incompetence and may increase the lower incisor exposure (LIE) that will cause an unaesthetic result. The aim of this study was to evaluate the extent of lip ptosis, LIE, and other soft-tissue changes following different types of osseous genioplasty procedures.Twenty-nine patients (18 females, 11 males) were included in this study. Patients were classified into 3 groups with respect to their genial movement type as genial setback (n = 10), genial advancement (n = 10), and vertical reduction (n = 9). Preoperative and postoperative lateral cephalograms were analyzed to evaluate the horizontal and vertical soft-tissue changes of the lower lip and chin in the 3 genioplasty groups. The statistical evaluations were performed with regression analysis. The mean increase in the LIE was 1.88 mm. Lower incisor exposure and soft-tissue thickness at pogonion were increased significantly in all patients (P < 0.05). Statistically significant differences for lower lip length and vertical position of soft-tissue supramentale values were detected in patients who underwent vertical reduction genioplasty (P < 0.05). Genioplasty procedures requiring the mentalis muscle release cause a 1.88-mm increase in LIE. Vertical positional alterations of the lower lip were especially observed following the vertical reduction genioplasty. Clinician should be aware of this consequence in the course of treatment planning.


http://www.ncbi.nlm.nih.gov/pubmed/24036810