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Witch Chin after Genioplasty (pix)

Witch Chin after Genioplasty (pix)

Postby chukcha1 » Tue Mar 13, 2012 3:53 pm

I had a rhinoplasty and sliding genioplasty done a year ago. I am very happy with my nose, but the chin is a disaster. I ended up with a huge witch chin, which became even more prominent when I smiled.

My PS revised it 5 months later and tried to attach the hanging muscles and tissue higher. It looked good as soon as he took off the taping, but shortly after the swelling subsided, the witch chin came back, although not as prominent. It is mainly obvious when I smile, it slides straight down.

Another problem is that my lower lip is inverted, so I don't have my feminine full lower lip anymore. This is definitely not what I was going for... My PS said he can go and try to attach it with a screw that will go through my teeth, but he said he has never done it and not sure. He said he never had this problem after Genioplasty, I am the first one. He thinks the muscles are not attaching to the bone for some reason. He also added a small artificial bone to my chin to make it look smoother. He said this is not what is causing the problem.

I am thinking to have him put my chin back, but he said he cannot guarantee the muscles will reattach. I wish I never touched it... If anyone has any ideas what this might be, please let me know :)

Here are the pictures Before/After side by side:
http://share.shutterfly.com/action/welc ... dqzYs2LEpg

Thanks for your support!
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Re: Witch Chin after Genioplasty (pix)

Postby Randy44 » Wed Mar 14, 2012 10:03 am

Try some botox in the chin, it may help with the pointy chin when you smile. 6 units total, 3 each side of the chin near the bottom of the chin.

Other than that I don't have much to add. One of the reasons I think implants are superior to sliding genioplasty is that the implant is easier to reverse.
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Re: Witch Chin after Genioplasty (pix)

Postby MissJ521@aol.com » Wed Mar 14, 2012 1:47 pm

Witches chin is often an errant fat pad (chin has fat pad) that 'ptosis' beyond the ledge of chin when smiling.

The solution would tend to be more in the venue of just making a cut under the chin and directly excising the fat pad more than it would be to reverse the genioplasty. However, that type of solution is probably best not explored with the doc who did your genio.

You do have what looks like "witches chin". But no way for me to tell you for sure if it's the fat pad. Clearly some soft tissue was displaced out of normal position with the genio you got.
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Re: Witch Chin after Genioplasty (pix)

Postby chukcha1 » Thu Mar 15, 2012 10:59 am

Thanks guys for the feedback... I know, I have a rare case. The worst part is that my mom is devatated, she cannot recognize me, and all the people around me, like "I told you so!" :( Ah...

Do you think the problem why it is not attaching in the right place because of the artificial bone he put where the tissue was attached before under my lower lip? I asked him and he said it is completely blended with my bones and cannot be the case... But obviously, something is not right.
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Re: Witch Chin after Genioplasty (pix)

Postby MissJ521@aol.com » Thu Mar 15, 2012 12:13 pm

Most likely, the mentalis muscle lost where it was once attached or anchored to the bone because your doc (most likely) used an incision inside your mouth and REMOVED the the bony anchoring point to where the mentalis was attached. That type of muscle attachment loss causes the entire chin soft tissue pad to droop or 'ptos' below the end of the chin bone. Like he probably did not do the surgery to re-attach the muscle.

So, I would conclude your problem is from your doc NOT reattaching the part of the mentalis he removed from it's original 'origin'.

It matters not if what ever he put in there 'blended with your natural bone'. What matters is the doc did not re-attach the mentalis to it's origin or re-attached it incorrectly as to lower its origin.

When you lower the origin of the mentalis muscle, you lower where it 'inserts' and hence moves the skin and lower lip when ever you use the muscle and that would explain the witches chin.

What he did was not 'rare'. It's quite common for a bumbling doctor who is not really well versed in the importance of re-attaching the origin of the mentalis, for what you have to happen.

If I were you, I would not depend on that doc for any more advice as to why that happened. Like if he does not know why it happened, you don't want to have him do surgery on it again. If he does know and is not telling you, he's just covering up for his mistake.
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Re: Witch Chin after Genioplasty (pix)

Postby suckerpunch » Sat Apr 14, 2012 9:00 pm

I too had the sliding genioplasty and hated the results. When touching my chin, I could feel where the bone had been advanced and a plate put in to secure it. I had the surgeon reverse the procedure which lessened my witches chin, but still looked nothing like before. I asked whether or not the genioplasty would give me a banana chin and my surgeon lied and said it would just advance everything forward. Another unwanted side effect is that the point on the inside of the lower jaw where the genioglossus muscle attached ( holding the tongue taught while sleeping on my back) was severed and brought on sleep apnea. The surgeon who messed up my genio also screwed up my nose, so at least you got it half right. Like Miss J said, I would go to someone else who has experience with fixing witches chins as the surgeon you went to would have done it right the first time if he was capable. Good luck, you still look good and there is a good chance that can be fixed.
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Re: Witch Chin after Genioplasty (pix)

Postby JohnSm » Wed Sep 19, 2012 9:11 pm

You looked so good in the before picture. I'm guessing the doctor cut the chin in a downward angle and moved it forward so now it's more projected but vertically longer at the same time. Maybe the error is that the angle of the cut is too big and that made your chin look too long. I hope you can revert it back to the old height. Good luck.
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Re: Witch Chin after Genioplasty (pix)

Postby JustMyself » Wed Jan 09, 2013 10:29 pm

Hi chukcha1,

I so appreciate you sharing your pictures. I am considering a sliding genioplasty too but I'm terrified I'm making a big mistake going through it. Were you able to fix it since you last posted or did it start looking a little better? Please give us updates. Thank you so much.
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Re: Witch Chin after Genioplasty (pix)

Postby jayjay00 » Wed Jan 23, 2013 12:17 am

Judging your before photos:

I roughly applied the rule of thirds to your photos.(Face horizontally divided into thirds with lines drawn at the hairline, eyebrow, base of the nose and chin. Approximate normal ratio of the middle third and lower third is 1 to 1.) Your chin height from the before photo was nearly perfect, if anything it was actually 1 mm longer than the middle third of your face, so you did not need to lenghten the height.

From the side it looks fine, if anything a very slight horizontal adjustment could have helped (under 6mm). Females can getaway with the chin being slightly back. Meaning from the side view the point of your chin does not have to meet your lower lip since having it slightly back makes the face appear more feminine. If you draw the 'e-line,' which from the side view is a straight line from the tip of your nose to the tip of your chin - the lower lip should be about 2-3 mm behind this line, your lip appears to be touching it, so only a slight chin projection was needed.

I think the rhino alone was enough to enhance your appearance, and a small implant or fat injection to the chin pad could have given you just enough projection.

One thing that is a little tricky is it appears you have a right to slightly acute angled labiomental fold (the fold between your lower lip and soft chin pad). Horizontal augmentation via genioplasty or an implant would make this slightly more acute, but if doing genioplasty this could be offset with artificial bone or implant material to push the soft tissue of the fold out.

Your after results are not bad, but not ideal. You might have fat injections or removal on or around the chin to help contour it. If you are considering surgery, go to a genioplasty guru.

I'm not a doctor, just someone who has researched the crap out of genioplasty. I have done many consultations, read forums, and medical journals. One thing I learned about doctors is they will always recommend what they know or are confident in doing as the end-all solution. If there is a better technique or technology out there, and it's beyond their training or expertise they won't mention it our of ignorance, pride or financial gain. So you need to be diligent and get different opinions and then cross check via references, before and after pics, etc... You will eventually have an idea of what needs to be done, and you need to find a doctor who's drinking the same cool-aid, or better yet is the one who made the cool-aid. Meaning does he concur with your thoughts, and offer sound reasons if he disagrees.

I'm thinking of getting rhino as well - at first I was going to have one surgeon do both on the same day, but now I'm leaning towards having a maxiofacial do my chin, and PS who only does rhino do my nose.
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Re: Witch Chin after Genioplasty (pix)

Postby jcatz1 » Wed Jan 23, 2013 7:08 am

I believe your chin/lip problem has more to do with the soft tisue issues rather than bone issues.

Did the doctor put anything over the step off above the osteotomy.

I believe the doctor was too aggressive in degloving the chin and may also have not done a proper mentalis suspension.

Examine your befer/after lower lip. It appears smaller and more retrousive, this is a result of the mentalis muscle scarring. I herd it is difficult to fix.

Barry Zide
Mike Yaremchuk
Henry Kawamoto
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Re: Witch Chin after Genioplasty (pix)

Postby jcatz1 » Wed Jan 23, 2013 7:11 am

By the way you're a beautiful girl.
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Re: Witch Chin after Genioplasty (pix)

Postby Chinx » Wed Aug 02, 2017 6:17 pm

Hi, I am currently facing the same issue. Had two chin implants removed hence faced with a witches chin similar to yours. Can you kindly let me know if you did anything to correct it?
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Re: Witch Chin after Genioplasty (pix)

Postby Samas » Tue Aug 29, 2017 12:17 pm

Chinx, you've responded to a 5 year old topic. You may not hear back from the poster. But I have something small to add.

Ever since my genio 10 years ago, I've been lurking on forums and posting occasionally due to chronic worsening issues that I think stem from my procedure.

From my experience, my advice to both you and the OP of this topic is this: either be willing to spend a LOT of money due diligencing the heck out of what you are considering, or don't do it.

My mistake was, well, first off, the person I am today would never have done any cosmetic procedure. But 10 years ago I was a very different person, and the error I made then was to consult only one surgeon, albeit a recommended one on some forums.

The procedure cost me $7,500 I believe, and I wanted to save money. But with these things...there are risks. Big risks. If I had to do it again, I would have budgeted another $3,000 just to travel and consult with at least 3 other top docs, and then make a decision.

Don't risk permanent damage to your face, or worse. Your face is a new face. If it isn't deformed, it's just different. Who you are inside is still the same. If you can somehow learn to accept your new face and then focus your attention to your soul, that's the path I recommend.

Otherwise, don't skimp. Spend the extra money for multiple consults and travel. Wish you the best.

Sam
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Re: Witch Chin after Genioplasty (pix)

Postby Chinx » Wed Sep 13, 2017 9:34 am

Very timely and beautiful reminder. Thanks Samas.
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