What would help with my issue? (Photo)

Dynamic chin changes are hard to effectively treat. photos of you not smiling are as important as photos of you smiling. It appears that you have a large chin pad and the bony chin is likely normal. Reducing the chin and/or performing a chin "tuck" may be helpful. Sometimes mentalis muscle resuspension is recommended as well and removing the plate and screws. I usually heavily Botox the chin to allow for less potential movement following whatever procedures are performed.

This is something we see frequently. I would expect to possibly readjust the soft tissue and muscle of the chin. This can possibly be done right in the office.

Chin ptosis is a very difficult condition to treat. For that reason it would be in your best interest to consult 2-3 experts on this topic, starting with a surgeon who did your genioplasty. Hope this helps.

To make an accurate assessment regarding the outcome of a cosmetic surgical procedure we generally always need to see instead of proper before and after pictures. If you don’t have before and after pictures and ask your surgeons to forward the pictures they took. It looks like there is some lack of volume between your chin, and where your jowls would form. This area could be augmented with fillers, which is the easiest, but temporary. Doing so would give you a good idea of what restoring volume in this area could accomplish.
If volume restoration looks really good then a custom-made implant could be placed. There may be other options available. Your situation is a bit complex and I suggest for now you work with your current provider. Based on the type of work you’ve had done if you want to second opinion consultations those are probably better scheduled as in person consultations with other providers who do this type of work. This type of work is not done by most plastic surgeons those some plastic surgeons especially those with plenty of facial surgery backgrounds may do these types of procedures. Advanced mandibular surgery is usually done by those with oral surgery background.
Best,
Mats Hagstrom, MD