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Technical Strategies in Plastic Surgery – Muscle Resuspension in Vertical Chin Reduction

 

While a short chin is both common and easily treated by an implant or bony in most cases, the long or big chin is a much more challenging aesthetic issue. The tissue excess over the front end of the lower jaw makes its reduction fraught with problems of redundancy and potential tissue sag. Where does all the soft tissue go if the bone that is supporting it is reduced or removed?

It is these soft tissue considerations that make an intraoral approach for chin reduction usually problematic. While a pure vertical reduction can be done by a wedge removal bony genioplasty from an intraoral approach, burring reduction or reverse sliding genioplasties ‘create’ soft tissue excesses or tissue sagging. These ‘new’ soft tissue problems will mar any aesthetic change that the bone reduction has accomplished.

A submental approach to chin reduction offers dual management of bone and soft tissue excesses. Through an incision under the chin, the soft tissues are initially freed off of the bone. The chin bone can then be reduced in any dimension whether it is vertical, width or horizontal projection. Once the bone is reduced, the amount of soft tissue excess becomes apparent.

Submental Vertical Chin Reduction Dr Barry EppleyThere are two types of soft tissues excesses created by a submental chin reduction. The first is the amount of skin, muscle and fat over the chin prominence that is removed by a submental excision and tuck. The second, which is most manifest in a vertical chin reduction, is the loss of the mandibular attachments to the infrahyoid musculature. If not resuspended there will be a resultant submental fullness due to muscle retraction.

Muscle Resuspension in Submental Chin Reduction Dr Barry Eppley IndianapolisResuspension of the released anterior strap muscles is done through bone holes placed through the new lower edge of the chin bone. Reattaching this muscle helps tighten the submental area so that its contour fits better to the reduced chin without an abnormal bulge in the submental soft tissue triangle.

Dr. Barry Eppley

Indianapolis, Indiana

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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.

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