What procedure would best suit my following issue? (Photo)

Hi Emily. Your retrusive mandible can be corrected by facial injections. The retrusiveness of your mandible does not allow you to close your mouth naturally, and this causes the closure of the lower lip to have a forced look which makes you look unhappy.

The reason for the problem is that the two muscles on either side of your anterior jaw called mentalis muscles have the job of closing your mouth by pushing up your lower lip. This normal closing process is inhibited when the profile of the mentalis muscles are not in line with your lower lip.

This anatomic mumbo jumbo, in short means, when the lower lip and the chin are not in the same vertical plane, the lip won't close naturally.

If you were my patient, I would do an injection of Volux, an Allergan product that lasts in my experience over a year, and sometimes up to two years. It usually takes 2-3 ccs to correct the retrusive chin. This can be done in an office setting with minimal discomfort. Since your bone structure has not fully matured, I would use an injectable rather than a surgery, and injectables such as Volux are completely reversible. The process should take less than 15 minutes, including topical numbing with BLT. To decrease bruising, I recommend both ice and DMSO.

A formal evaluation would be needed to determine the best treatment. There are surgical and non-surgical options to correct this.

We can place a chin implant, which is a quick surgical procedure. Many of my patients try to avoid surgery, however, so for those patients, we also offer non-surgical chin augmentation with injectable fillers. Fillers like Radiesse, Voluma, BellaFill, and Sculptra are injected into the area to improve the overall appearance of the lower face and balance the jaw and lip harmony. We use cannula injections to meticulously contour and project the chin, soften the chin along the jawline, and improve the chin crease.

Implants are a great option once you are 100% positive that you are ready for permanent chin enhancement.​ I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or aesthetic facial plastic surgeon; we have both at our practice, which is located right here in Los Angeles.

Best, Dr. Emer

Dear Miss Blumel,

Thank you for your pictures. They are very helpful. In a perfect scenario since you are in orthodontic treatment, this may be the best time if your orthodontist thinks that the surgery is important not only to your bite, but to your facial profile then this would give you the profile that you desire. If you are not to have jaw surgery, but complete orthodontic treatment, the most reasonable treatment would be to have a sliding genioplasty to balance your facial profile. Seek consultation from Plastic Surgeon or oral and maxillofacial surgeons to render the best opinion concerning your issues.

Best wishes!

Earl Stephenson Jr, MD, DDS, MBA
ESJ Aesthetics
#TruthAndTransformation,