Correction of chin ptosis is like lateral canthopexy. Some surgeons perform it routinely and others shy away. Although both procedures are anatomically uncomplicated, some mysterious forces stop the surgeon, and these forces relate to the patient’s desire for perfection and the surgeon’s ability to deliver. This article deals with noniatrogenic ptosis and offers an appealing, although somewhat flawed, schematic for correction.
When the illustration does not equal the real anatomy, problems arise for the surgeon. Anatomically, the drawing is very incorrect and should have been changed. The mentalis arises immediately submucosal in the sulcus for a centimeter or so; there is no space as drawn. The muscle never arises as it is drawn partly from pogonion, and the fibers go right into the dermis, which is also not depicted properly; the platysma comes to and often covers the menton; it does not insert into the genial tubercle.
First, let us consider some basic concepts regarding the ptosis examination; second, let me assess and analyze their process of correction; and third, let me provide some simple caveats.