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Oral Surgery/Drooping lip after genioplasty

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QUESTION: I had sliding genioplasty and revision genioplasty. My mentalis muscle now droops, dimples and my lip droops on one side. There is a cyst under the non-drooping side of the lip that might be contributing to the appearance. Is it the muscle likely causing the lip to be crooked? Can this be fixed?

ANSWER: Vic - it is a little difficult without examining you, but the drooping could be from a poor alignment of the tissue, too much stretching of tissue on one side or it could be some minor trauma to the nerve that affects the muscle tone of the lip.

To repair, the cause needs to be determined and then correct the situation.  I'm not sure if the area can be made equal to the other side after the trauma, but you need to see an evaluation directly with a different plastic surgeon or oral and maxillofacial surgeon,

If you have additional questions, feel free to contact me again.

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chin
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QUESTION: Thank you so much. How is the cause determined, especially if it is a nerve? What do you mean by poor alignment of the tissue - does this imply mentalis resuspension? Is mentalis resuspension just suturing the muscle back together? What happens if there were different incisions to access the chin; does this make drooping and dimpling worse?

Answer
Vic - The nerve testing is very simple and has to do with you mouth movements and testing for a lack of sensitivity is some areas to a stimulation like an ice cube or a pinprick.  

Poor alignment means that the doctors, in attach the bone after movement, might not have lined it up perfectly.  Also when the sutured the area, the sutures might have pulled one side more than the other.  Additional incisions in the area might definitely add to the changes you see.  There is no perfect result, but the doctor who did the surgery needs to discuss options with you.  

I know you notice changes, but from the picture I can't see the cyst, but it sounds like the tissue was pulled to close the wound and that could change the appearance.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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