EXPLORE
Plastic Surgery
Dr. Barry Eppley

Explore the worlds of cosmetic
and plastic surgery with Indianapolis
Double Board-Certified Plastic
Surgeon Dr. Barry Eppley

Posts Tagged ‘chin ptosis correction’

Vertical Excision Technique for Chin Ptosis Correction

Monday, March 2nd, 2015

 

The number of different procedures available for correction of chin ptosis (chin pad ptosis) indicates that there is no one single procedure that works the best. While chin ptosis correction techniques vary, it is important to appreciate that there are different anatomic variants of chin ptosis. There are contributions of bone, skin and fat, mentalis muscle and lower lip positioning. Together these create different types of chin ptosis problems.

vertical wedge excision for chin ptosis correction 1vertical wedge excision for chin ptosis correction 2In Volume 3 Number 2 2012 issue of Plastic Surgery Pulse News, an article appeared entitled ‘A Novel Correction of Chin Ptosis By Vertical Wedge Excision of Subcutaneous Soft Tissue’. Using a single patient example, the authors describe a vertical midline wedge excision of soft tissue. In this technique the vertical laxity of the ptotic chin pad is tightening along the inferior border of the chin mental border while correcting the horizontal tissue laxity as well. The technique also improves anterior chin projection and softens the labiomental crease as well. This vertical wedge of mentalis and soft tissue when brought together creates a clothesline effect that helps reposition and suspend the ptotic tissues up over the lower anterior border of the mandibular symphysis. In the process, the soft tissues of the chin pad are rotated upward, augmenting the anterior chin and re-creating the labiomental fold. Any excess skin and subcutaneous fat is then trimmed in a horizontal fashion in the submental region.

Muscle Resuspension in Submental Chin Ptosis Correction Dr Barry Eppley IndianapolisThis vertical wedge excision technique for chin ptosis correction is based on tissue excision rather than tissue resuspension. That is a fundamental difference and requires an appreciation of whether the patient’s chin ptosis has a component of excessive chin tissues or not. By using a vertical excision of chin pad tissues, a vertical triangular excision creates a clothesline effect that allows the remaining chin pad to be positioned superiorly and anteriorly. It is easy to see why this technique could cause an abnormal bunching of chin tissues if the chin ptosis was caused by laxity and not excessive tissue as well. The authors acknowledge that this technique is not useful for every chin ptosis problem, particularly when there is already too much chin projection present.

Chin ptosis is a multifactoral problem that has different anatomic variants. The first important classification is whether the chin ptosis is associated with a lower lip sag or not. If there is no lower lip sag there is no benefit to mentalis muscle resuspension or trying to move the chin tissues back upon the one. The next important chin ptosis classification is whether there is excessive chin tissues or whether there is a normal amount of tissue volume. If the overhanging chin tissues are normal in volume, and their resection may be associated with causing a lower lip sag, then resuspension should be done. When the ptosis is caused by excessive chin tissues then resection would be the appropriate approach.

When it comes to resection of the chin pad, it can be done horizontally (under the chin), vertically (as shown in the article) or through a combined vertical and horizontal technique. (inverted T) There is no question that adding a vertical direction to the chin pad excision provides an additional element of chin pad reduction that is helpful.

Dr. Barry Eppley

Indianapolis, Indiana

 


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

Read More


Free Plastic Surgery Consultation

*required fields


Military Discount

We offer discounts on plastic surgery to our United States Armed Forces.

Find Out Your Benefits


Categories