Is lack of chin support usually the cause of a droopy lip?

[Purist]

I was wondering if a droopy lip is usually caused by lack of chin support, i.e. in a case of a severely retruded chin and if an SG or implant would remedy this OR would it do the reverse and pull the lip even further down?

[kjohnt]

Can be.  I don't know for certain but I've thought about it a lot and this is what I think:

A lower lip which curls excessively is likely due to a high soft tissue to hard tissue ratio.  More bone tissue will provide more support for the skin and stretch it.  A sliding genioplasty may help a little but likely not much.  Mandibular advancrment is likely the answer along with up righting lower incisors.

Also maybe just too much soft tissue.

[Purist]

I know it sounds like stating the bleeding obvious but I also have a very narrow jaw. My thinking is will a custom implant that widens the jaw, pull the lip back into its correct position.

[kjohnt]

Tough to say for certain, but I believe it will.  More bone (or implant) in any direction will make the skin more taught and pull loose/saggy/droopy soft tissues into place.  This is only my theory.

[Purist]

I have enquired about an implant in the past and was told it could cause (in my case) a hyperactive mentalis which put me off.  Botox injections been the fix.

I was also told by a surgeon that an SG would cause a witches chin appearance (which I thought was more implant than SG)  I may revisit that again sometime, but I don't believe an SG widens the jaw so I may stil end up with a droopy lip.

[kjohnt]

It sounds like you're a jaw surgery case

[Purist]

In what way? SG or BSSO? No orthodontist will touch me and I've seen five in 12 months which rules out BSSO.  That's why I'm mulling over an SG / implant.

[kjohnt]

I've never seen your pictures man and I'm not a psychic.  Based on that a surgeon said no to SG I thought BSSO.  But 5 ortho said no to BSSO, you may not need anything.  I'd personally consult with more surgeons, not orthos, and at least post pictures up if you want meaningful advice here.

[Purist]

With double jaw surgery ruled out I'm kind of thinking if an SG would help or maybe even a custom implant would push the lip up some.

[attachment deleted by admin]

[kjohnt]

That's your ceph?  The doctors with whom you've spoken must be absolutely retarded.

Your occlusion is class ii, and your lower incisors are overly proclined.  You may need lower extractionsprior to orthodontics in order to create enough space to upright those incisors.  When teeth are properly positioned, your overjet will be worse than current.  Then BSSO to close overjet and for sure sliding genioplasty as well because your chin is severely deficient.  Likely bimax but not sure how maxillary will be addressed... I'd guess very minor anterior impaction for CCW movement and adding a few mm projection.

[PloskoPlus]

That's your ceph?  The doctors with whom you've spoken must be absolutely retarded.

Your occlusion is class ii, and your lower incisors are overly proclined.  You may need lower extractionsprior to orthodontics in order to create enough space to upright those incisors.  When teeth are properly positioned, your overjet will be worse than current.  Then BSSO to close overjet and for sure sliding genioplasty as well because your chin is severely deficient.  Likely bimax but not sure how maxillary will be addressed... I'd guess very minor anterior impaction for CCW movement and adding a few mm projection.

I'd hazard a guesss... Surgeons may be afraid of a bad break - the mandible looks very small. AFAIK, gunson has been able to fix worse.

OP, I believe some NHSs can pay for your treatment overseas if you can prove that you need treatment and cannot get adequate care at home. But then again you don't have cancer or something life threatening. You probably have sleep apnea.

[Purist]

That's my ceph. alright.

I've been turned down twice for double jaw surgery in fourteen months.   I think the sticking point is my age - I'm in my forties.

The deficient mandible is really knocking my self esteem and I am considering an SG to at least add some normality to my profile.  Functionally I feel Ok. I'm wondering if a two-tier SG would fix this, since the deficit is 16-20mm I would guess.  I don't know and I feel like I'm going around in circles (another surgeon said an SG would be bad).

I have two new consultations soon (one tomorrow).  Hopefully something may come out of it.
 
No sleep apnea.