Sliding Genioplasty

Q: Dr. Eppley, I am really confused about the types of surgery best suited for me. I do know that my face is too masculine. My cheekbones are too wide, my jaw is angular, and my chin is too long. I have no facial fat or cheeks. I am also wondering about an eye lid and upper and lower lip lift, or some type of lip contouring or mouth reshaping. I like full lips, but my lips seem to protrude and the top lip is really wide when smiling. I don’t know if I need a jaw reduction, chin vertical height reduction, or sliding genioplasty with a reduction in height.I would also like rhinoplasty and possibly a facelift. Overall, my face is just not feminine at all to me and my hair line and forehead looks masculine too. Thanks for your help.

A: Thank you for your inquiry. Based on an assessment of the pictures you sent, let me try and provide you some direction. First of all, let’s start out by eliminating what you don’t need, won’t work or isn’t worth the aesthetic tradeoffs. You would not benefit by a facelift, eyelid lifts or lip lifts. There is nothing you can do about your lip protrusion or how far the upper lip moves when smiling. Your cheek bones are not too wide but they do lack any anterior projection. (fullness) That lack of projection makes you think your cheekbones are wide when they are not. Cheek augmentation here may be beneficial.

Your biggest issue is that your lower jaw is short and angulated downward. This makes the chin horizontally short but vertically long. An intraoral bony sliding genioplasty to vertically shorten your chin and bring it a little forward would be very helpful in getting away from a masculine look.

Your forehead looks masculine to you because it slopes backward. Forehead augmentation to create a more projected and convex forehead shape would make it look more feminine.

In short, your face appears masculine because of its skeletal structure. These are bony issues and changes in the shape of the facial skeleton of the chin, cheeks and forehead would create the appearance of a face that has more anterior projection and less vertical height.

Dr. Barry Eppley

Indianapolis, Indiana