Are The Wires from My Sliding Genioplasty The Source Of My Nerve Pain and Numbness?

Q: Dr. Eppley, I’m writing with regard to the sliding genioplasty revision that I was discussing with Dr. Eppley a few months ago. I would like to do this, but I have a question about removing the surgical steel wires that were used. I am experiencing nerve pain and numbness on my lower lip and chin, and I wonder if removing the wires could help with that. I wonder what the best timeline would be. Should I have the original surgeon remove the wires as soon as possible, and allow time to heal from that before doing the revision with Dr. Eppley? Or, would it be best to wait and continue healing and have the wires removed at the same time as the revision with Dr. Eppley? The surgery was done last June, and the step off is visible on my right side. My original surgeon wants to do a revision genioplasty, but I’m not sure he will be able to correct it, and I don’t think I can risk worsening the nerve pain. He is alternatively offering to do a fat transfer to the step off, and to only remove the wires. I have a pretty pronounced inferior border that sticks out, and I also wonder about burring that down a bit before the step off is filled in with the gortex strips. I wonder about additional cost for removing wires, as my original surgeon will charge only the surgical center fee. I apologize for the long email, and appreciate any feedback.

A:When it comes to the wires used for a sliding genioplasty they usually are placed nowhere close to the mental nerve. Persistent numbness and discomfort after sliding genioplasty like you have described is more likely a reflection the original bone cut and the surgery required to do it. Thus I would doubt that the wire removal is going to help much in that regard. However I have not seen a postoperative Panorex x-ray to confirm if that statement is accurate. Fat transfer in general is often not a great treatment for a bony deformity. However if your economic commitment is low to have the wires removed and the fat grafting done I do not think there’s any harm in doing so.

Dr. Barry Eppley

World-Renowned Plastic Surgeon