Trouble with bad lip posture and mentalis strain after BSSO

[Courtfar]

Hello, I joined this forum about 10 years ago. At the time, I was considering sliding genioplasty to correct mentalis strain due to lip incompetance. I found this forum while doing research on the procedure. I went through with the sliding genioplasty. The surgeoun that did it did not recommend jaw surgery at that time. He thought it would be a lot more than necessary to give me a nice chin. He advanced my chin and shortened it a little and I was pleased with the result. No more lip incompetance or mentalis strain.

8 years later, I ending up having to see a different oral surgeon about some TMJ issues and this one recommended orthognathic surgery and braces to fix my bite in order to treat the TMJ. So, after a year and a half of braces, I had a BSSO to correct an overbite. I was concerned about how the jaw advancement would compliment by previous chin surgery but he assured me everything would be okay.

So, here I am 9 weeks post op...and the problem I'm having is that it's very hard for me to close my lips and it cannot be done without significantly straining my chin muscle. I hate it! I expressed my concerns during the last two follow up appointments but the surgeon just keeps encouraging me to give it more time.

I'm very worried...the genioplasty I went through years ago helped my mentalis strain and gave me a nice chin. Now is seems like the lower jaw advancement undid it?! Is that even possible? I don't like the way my chin looks anymore. Is this normal at this stage after surgery? If it's just a matter of retraining the muscles in my face, is there anything I can do to help the process?

[Sarah96]

How much movement had been done? Also, do you think your face is longer than before? I don't have an idea but maybe it's because when they moved your lower jaw forward, due to your gonial angle it became longer and caused your chin to go down?
That's the only think I can think of right now. Do you have a photo before and after?
I don't know if it's normal after 9 weeks. I have a similar problem and i am almost 4 weeks post op so I also try to find a solution.

[kplatt2010]

Hi Courtfar,
Are you currently in treatment with braces? If so; you will notice changes in your appearance and with the chin / mouth closure issue as treatment progresses. Following the surgery, when my lips were relaxed, they were wide open. As I've gotten further along with orthodontics, I'm able to close my lips in a natural relaxed pose.

[Courtfar]

Thank you for the responses. Sarah, my jaw was advanced 6mm. That’s a good point you made. I saw my doctor again yesterday and he still isn’t doesn’t want to talk about it until I’m healed.
I do have braces but I had them before the bsso and lip incompetence wasn’t a problem then.
Thanks again, I’ll be sure to update as things progress to help others who might be experiencing the same problems.

[Courtfar]

Let’s see if I can share these pics.

This is right before surgery

https://s8.postimg.cc/s7xdx83m9/4_D9_EB ... CB7_F3.jpg

2 months post op, relaxed

https://s8.postimg.cc/er0fedgg1/0_F0_DB ... 67_A02.jpg

And lips closed

https://s8.postimg.cc/er0fed8q9/46_D03_ ... 1_A786.jpg

[kplatt2010]

You know honestly you still look like you have swelling going on. It took me a good six + months and I don't think it was completely gone till close to the year mark.

Do you feel like your face is still swollen?
Karla

[Courtfar]

update:
It's been just over 3 months since my bsso. Swelling has gone down significantly. One day I just looked in the mirror and recognized myself again. I am sure that has helped a lot. Also I have been doing some muscle retraining exercises several times a day. I followed some of these: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190816/ and another exercise where, with closed, push your lower jaw out and lift your lower lip until a stretch builds just under the chin and in the jawline.
I have seen a reduction in mentalis strain and improved lip closure and I am satisified with the results so far.

[Sarah96]

It's nice to hear you are satisfied with the results now. And thank you for the link!