Can A Chin Implant Be Added for Width After A Sliding Genioplasty?
Q: Dr. Eppley, I asked you a couple weeks ago about the graft to fill out the labiomental fold and you said the bone graft used to vertically lengthen the chin would naturally help flatten the fold. I realized today, though, that what I was wondering about is actually a fat graft.
I found a photo in the chin surgery gallery on your website that refers to what I was talking about, on “Patient 49”. It says “intraoral placement of dermal-fat graft for labiomental fold reduction”. I’m wondering if this is part of our current plan, and if not, whether he thinks it would be helpful or necessary.
And last I’m wondering, if I did opt for an implant in the future for the purpose of adding chin width, what minimum/maximum dimensions could or would an implant add vertically and horizontally as a byproduct? My thinking is that if genioplasty can only add a max of 12 mm vertically but an implant could add an extra few mms on top of that, then that would be an added advantage of the implant overlay. And if we only needed 5-8 mm of horizontal projection with this surgery but an implant would add a few mms minimum laterally, then we’d want to account for that with the genioplasty. Or maybe the implant can be customized so that it adds 1-2 mms vertically and 0 mms laterally.
A: It would not be prudent to place two nonvascularied grafts right next to each as that increases the risk of infection. So no a dermal-fat graft is not placed at the same time as a tissue bank bone block used with a vertical lengthening bony genioplasty.
As a general rule a few millimeters horizontally and/or vertically is what can be accomplished by a secondary overlay implant after a bony genioplasty.
Dr. Barry Eppley