Q: Dr. Eppley, I had a sliding genioplasty to narrow my chin. I told the doctor that them when I smile, my face looks big at the side of the chin so he mentioned that he’s gonna cut or reshape the bone there and remove some muscles. I’ve attached the photo of the before and after surgery. Because after I did this, every time I smile or not even smiling, I see my line around my chin area looking like someone took a bite out of it and the bone there’s gone. Also I feel like my chin is more narrow not like before. I really don’t mind if it’s making my chin comes forward, but not like before. It is possible to reshape the chin bone in any way. Or just simply just cut the middle and then put the bone in front?
A: Based on your pictures and the x-rays, what you had done was a sliding genioplasty that brought your chin forward and up a bit as well as had a central wedge taken from it to narrow it. This is clearly evident in the x-rays and by the plate fixation used. What this has done, and is not uncommon, is to narrow the chin but there is a step off at the back part of the osteotomy cuts. I see where no other bone has been removed…and certainly no muscle or soft tissue has been removed. This has left you with a chin that is now too narrow for the rest of your jawline…hence your interpretation that it looks like a bite has been taken out of the jawline behind the chin. (hollow part)
You have two options to consider for your sliding genioplasty revision. Probably rather than moving the bone back, which can be done, you could simply fill in the bone defects left along the jawline. (provided you are satisfied with the way the front part of the chin looks)
Dr. Barry Eppley