Mentalis Resuspension: Case I
A Case of Correcting Chin Muscle Ptosis After Facial Contouring Surgery
(Mentalis Resuspension for Witch’s Chin)
Correction of Chin Muscle Ptosis After Facial Contouring Surgery
(Mentalis Resuspension for Witch’s Chin)
Chin contouring surgery corrects conditions such as a protruding chin, a receding chin, or a wide chin.
Among these, the procedure that corrects a protruding or wide chin to create a slimmer line,
“V-line chin surgery,” is the most widely known method.
In chin surgery, after an intraoral incision is made,
the muscles attached to the chin bone and the lip muscles are dissected,
and the bone surgery is then performed.
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After the bone surgery, the muscles must be reattached to the bone;
however, when a silicone implant is inserted or the bone is reduced in size, the muscles become loose,
fail to adhere closely to the bone, and begin to sag.
This condition, in which the muscles fail to adhere and the chin sags,
is called a “ptotic chin” or “Witch’s Chin.”
How the Muscles Sag After Chin Surgery
The illustration on the right shows how the muscles sag after chin surgery.
The upper illustration shows the attached muscles sagging downward (in the direction of the arrow) when bone is resected or an implant is removed.
The lower illustration shows that not only do the chin muscles sag, but the lower lip and the groove below the front teeth (vestibular sulcus) also drop down with them.
When this sagging occurs, the mouth does not close well, and the gums show excessively when smiling, which is aesthetically unfavorable.
From the front as well, the area under the chin bulges and sags downward, making the chin look longer.
A Case of Correcting Chin Muscle Ptosis After Facial Contouring Surgery
(Mentalis Resuspension for Witch’s Chin)
This patient had undergone surgery for a receding chin at another clinic 1 year earlier, with a silicone implant placed in the chin.
After the surgery, however, the mouth did not close well, and the chin implant was removed 6 months later.
Even after the chin implant was removed, the mouth still did not close well, and the lower lip sagged downward, exposing the lower teeth and gums.
When the patient forced the mouth closed, the chin dimpled like a walnut, giving an unnatural appearance.
The preoperative photo shows the patient relaxed and at rest: the gum line of the lower teeth is visible and the mouth is not fully closed.
From the side as well, the mouth did not close well and the tip of the chin sagged downward.
The closed mouth looks unnatural, and it can be seen that the lips close only with effort.
Surgical Procedure (Mentalis Resuspension)
In this technique, holes are drilled in the bone below the lower gums, and the sagging chin muscle (ptotic mentalis muscle) is pulled upward and fixed in place.
Before surgery, in the relaxed state (rest position),
the lower lip sagged downward, the lips did not close well,
and even the gum line of the lower teeth was visible.
After surgery, in the relaxed state (rest position),
the lower teeth are fully covered and even the upper teeth are naturally covered,
and the chin can also be seen to be shorter from the front.
Before surgery, the tip of the chin sags downward.
After surgery, the sagging muscle at the tip of the chin has been lifted,
and the chin can be seen to be shorter.
The lips also close more naturally.
Before surgery, the patient had to strain to close the lips, and the chin tensed and wrinkled;
after surgery, the lips close naturally without straining the lips or chin.
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