Chin Wing Osteotomy

Q: Dr. Eppley, Thank you for your amazing job you do as a surgeon and to inform all the patients online. I know (as read on your site) custom implants would be my best choice. However, i really do not want implants, there’s a 0% chance of me getting implants. A friend of mine had a “zygomatic osteotomy” and a “chin wing osteotomy” and I think his results were very good.  Do you perform these surgeries? Do you use some bone grafts? Why would you, or why wouldn’t you recommend the following procedures’?

A: When one tries to compare different facial reshaping operations it is important to carefully investigate up front what dimensional changes they can actually make. I have perform many zygomatic osteotomies (for cheekbone narrowing and cheekbone widening) as well as the chin wing osteotomy. The zygomatic osteotomy provides width and width only to the zygomatic arch and the very posterior aspect of the zygomatic body. It can not provide any anterior projection to the cheek as that is not the direction that the bone moves. The interpositional gap created by the zygomatic expansion osteotomy can be grafted by bone or an hydroxyapatite block. The chin wing osteotomy is useful for two types of jawline changes. It is primarily useful in creating a sliding genioplasty effect where the entire jawline is moved as the chin comes forward and downward. It can also be used to vertically lengthen the entire jawline.

The only reason I ever do these types of facial osteotomies is when the patient wants to do a ‘natural’ operation as opposed to the use of custom facial implants for a very specific type of facial dimensional change as outlined above.

Dr. Barry Eppley

Indianapolis, Indiana