How Can I Improve My Mouth and Lip Tightness after Double Jaw Surgery and Genioplasty?

Q: Dr. Eppley,  I’m experiencing complications following DJS and genioplasty – specifically extreme tightness in my chin at rest (gets worse when smiling or talking) my lower lip is curled in and the outside corners are being pulled down, new lip incompetence (did not have prior to surgery) I’m exploring genioplasty revision options but I’m concerned that reversing the forward movement of the chin might contribute to more lip incompetence since there was CCW movement in the maxilla. I’ve included my before and after planning images. The maxilla was advanced 3mm forward and CCW rotation, the lower jaw BSSO forward movement was 7mm, and the genioplasty was another 6mm. I am very petite and I’m concerned that these movements were too aggressive. I can hardly sleep with the tightness constantly pulling on my chin and the mouth breathing issue is also constantly disrupting my sleep.

A: The bony movements alone do not explain your symptoms. The amount of forward chin movement (6mms) is not excessive even when combined with a mandibular advancement….at least by the numbers. How it looks aesthetically I can not say as you have provided no before and afters to evaluate.

This sounds more like intraoral chin scar contracture of which its treatment would be either a subtotal genioplasty reversal, an intraoral scar release and dermal-fat graft or a combination.

Dr. Barry Eppley

World-Renowned Plastic Surgeon