Mentalis Resuspension of witch’s chin, ptotic chin
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ptotic chin
chin ptosis
Mentalis resuspension
It’s not rare to encounter the many problems of chin ptosis after osseous genioplasty,
augmentation genioplasty with implant insertion, and removal of metal plate and implant.
The various appearances of chin ptosis after chin surgery are
drooping of chin soft tissue(witch’s chin),
tight an pulling down sensation of chin,
exposure of lower teeth at rest position and unnatural lip movements.
For doing osseous genioplasty, intraoral incision is made at first,
followed by dissection of all the muscles and
soft tissues of chin from the bone, and bony work at last.
After completion of genioplasty, the chin muscle can be drooped due to detachment of mentalis
muscle from it’s origin followed by reduced bony framework and loosened muscle tension.
The technique of mentalis resuspension can make the detached and drooped chin muscle lifted
and repositioned to int’s original position, and make the muscle motion normal
This surgery makes the patient feel comfortable and
move naturally by making an incision of 3-4cm in the mouth,
removing the front jaw muscles and fixing them to the upper gum bone.
Schematic diagram ofWitch's Chin
This is a picture of the process of the mentalis
muscle sagging after chin surgery.
The upper picture shows that the mentalis
muscles drooped down after chin bones are
resected or the prosthesis is removed.
The lower picture shows that not only the
mentalis muscles droop, but also the lower lips
and the vestibular sulcus in front of the lower
incisors fall down.
If it happens, the lips can not close well, and
the lower teeth are visible on relaxed position,
and gums are visible when smiling.
The soft tissue of the chin is bulging
downward, and chin looks longer.
Preoperative Examination
PH
8-9 years ago, she had malar reduction and osseous genioplasty of T osteotomy.
CC
Hard to close her lips and should strain to close her lips. Long and drooped chin.
Show walnut wrinkle on the chin when close her mouth.
P/E
Strain to close her lips and chin. Shows walnut wrinkle to close her mouth.
Exposed lower teeth on rest position long and drooped soft tissue of chin.
X-ray
She has plate and screw on the chin bone.
Tip of the chin was drooped.
The closed lips look unnatural.
Mentalis Resuspension
Procedure of Mentalis Resuspension.
Lift the mentalis muscle and fix it to
the gingival bone through the drill holes.
The x shaped metal plate was removed
during the operation.
Before the operation, her lower lip was dropped
down to show her lower incisors on rest position.
The lower incisors are not visible any more on rest position after the operation.
The length of chin was reduced.
Before the operation, she should strain to close her lips ad shows walnut wrinkles.
After the operation, she could close her lip without strain to close and no more walnut wrinkles.
Her lips look unnatural on closed position,
and tip of the chin soft tissue was dropped before the operation.
But it became natural and no more dropping.
More natural lip appearance and no dropping of chin after the operation.
mechanism of mentalis muscle drooping / Jaw surgery / mouthcomfortably / periodicconsultation /augmentationgenioplasty/ frontchin / frontjaw / witch’s chin /chin strain