Will A Sliding Genioplasty Improve Sleep Apnea?

Q: Dr. Eppley, I am scheduled to have a sliding genioplasty next month and I just wanted to clarify some things. Is there some sort of guarantee I get that this procedure it would improve or completelyy resolve my sleep apnea? Otherwise I don’t see any other benefit other than the profile improvement which would not be worth the surgery risk.

A: The simple general answer to your question is no. There are no guarantees in plastic surgery of any specific outcome. Any surgery is an educated guess that doing a certain maneuver will cause a specific effect. In some surgeries, experience may show that a certain outcome is very likely if not highly predictable. In other types of plastic surgery, the outcomes are less predictable and may, in some cases, be more hopeful than completely predictable.

When it comes to a sliding genioplasty, both sides of these potential outcomes are seen. It is a predictable fact that moving the chin bone forward will change one’s profile and give a stronger chin appearance. Once can debate whether the chin changes net a patient’s expectation but there is no debating that the chin position will change. When performing a sliding genioplasty to help improve sleep apnea, the results are less assured. In theory, when moving the chin forward the tongue is likewise brought forward somewhat due to the attachment genioglossus muscle between the tongue and the back of the chin bone. This is actually the basis of the historic genioglossus advancement procedure done for sleep apnea when a sliding genioplasty is not being performed. To be successful for sleep apnea improvement, the sliding genioplasty movement must usually be significant (greater than 10mms) and one should have a very short or horizontally deficient chin. (indicating there may be posterior tongue prolapse)  Often a lateral cephalometric x-rays will show the position of the base of the tongue to the posterior pharyngeal wall with a narrow airway space. But because the sliding genioplasty moves the front position of the tongue more forward than the back (closer to the point of pull), the amount of chin bone movement does not translate in a 1:1 ratio to what occurs further back at the base of the tongue and the posterior airway opening. This is the anatomic variable in whether a sliding genioplasty will help improve sleep apnea symptoms.

Dr. Barry Eppley

Indianapolis, Indiana