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Plastic Surgery/Scar tissue after jaw and genioplasty surgery.

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Question
I had double jaw surgery and at the same time my doctor suggested chin surgery where my chin would be moved forward. Then my lower teeth were exposed (at least I thought) because I was looking at other pictures taken before at the clinic and I do show lower teeth but in a natural way. Anyways I thought my lower teeth were exposed because of bad muscle attachment. I went to another surgeon and he did mentalis muscle resuspension. At the time I thought it was the muscles. So I did the surgery. Then after the swolleness went down it is still the same, it didn't go up, he removed the plate for the genioplasty. But everything is the same. Then I notice my profile, the upper lip with the lower lip do not line up. The lower lip looks more back (so no way it can be the muscles). When I closed my mouth before the first surgery my bottom lip even tho it showed lower teeth naturally, my lip was fine and lined with the upper lip. The reason I can tell it's a scar tissue is because when I pucker my lips like if I want to kiss, you can see the spot where the incision was made is indented and it doesn't move. If I try to move my lower lip up, up right, up left, I can move it but that spot between the chin and lower lip is stiff. And if I put my tongue inside my mouth between the lower teeth and lower lip it feels tight and like a bump. I already had one shot of kenalog, 5 weeks ago and nothing happened, I have heard that sometimes it takes up to 3 shots for it to work. I have also heard 5FU shots help in scar tissue. I don't believe my problem is lip ptosis because my lip isn't drooping, I heard people here on the internet say about that and I've seen pictures of them but mines isn't like that, mines is the lower lip being like push behind so instead of the upper lip aligning itself with the lower lip it isn't. Again say I pucker my lip like I'm giving a kiss, that part is still. Is 5FU good to use or kenalog as well?

Answer
sounds like a complicated issue and honestly it is difficult to offer suggestions without examining the person. one option is to go back to your surgeon or go to aplastic surgeon if so far all the surgery has been done by maxillofacial specialists.
for the scar in the midline of your lower lip, a scar revision is more efficient than kenalog or 5Fu. only if surgery is not indicated, will i consider these two agents.
My suggestion is for you to consider seeing a plastic surgeon with reconstructive background and consider if scar revision would help.  

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Mohan Rangaswamy

Expertise

I am a certified plastic surgeon with special interest on aesthetic surgery, practising in Dubai, U.A.E. dealing with patients form diverse nationalities. You can address questions to me on body and facial aesthetic surgery (liposuction, breast surgery, nose corrections, eyelid surgery, fat injections, botox and fillers) as well as reconstructive surgery. I also have experise in the area of peripheral nerve surgery such as carpal tunnel syndrome and other nerve entrapments. I would especially welcome queries from net-surfers from this part of the world.

Experience

I have 17 years experience in reconstructive plastic surgery and over 12 years in aesthetic surgery. After qualifying as a general surgeon, I was fortunate to work in a unit that did complex reconstructive surgery and general surgery as well. This spurred my interest in plastic surgery as a career as the possibilities seemed to be amazing and limitless. This was the era when microsurgery and flaps captured our imagination. I further acquired formal training in Plastic surgery, burns, maxillofacial and hand surgery. this was followed by a training apprenticeship in aesthetic surgery. In my practice as a plastic surgeon, I do more aesthetic work now and am keen on developing minimal invasive surgery. I am a member of the Association of Plastic Surgeons of India, International Society of Aesthetic Plastic Surgeons, Royal college of Physicians and Surgeons, Glasgow, U.K.

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Professional: Plastic and Reconstructive surgery journal, Acta Tropica, European journal of OB & Gyn etc.

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