Can A Sliding Genioplasty Be Done Before A Total TMJ Replacement?

Q: Dr. Eppley, My daughter has been diagnosed with Treacher Collins syndrome and has a concave face. However, her bite is fine, with orthodontics and she has a slightly thinned cartilage (in her TMJ). One surgeon suggested she go for a Total joint replacement, rather than a double jaw surgery since her jaw joint is not stable and may/could get worse with time. I was wondering if I could just do a genioplasty for her for now, to see if we could wait and watch before we proceed for DJS, if she’ll need it in the future. Her airway measures 8mm but so far no symptoms of sleep apnea or tiredness. Thank you

A: Thank you for sending your inquiry and sending her pictures. It is not unreasonable to consider just a genioplasty for now as, even if she ultimately needs any of the other procedures, she would still benefit from an advancing genioplasty anyway.

Given her very short lower jaw/chin she likely would need a jumping genioplasty to get the maximum benefit from the procedure. It would be helpful to have some imaging done beforehand to check how much chin is actually present to be sure the operation can be successfully done.

Dr. Barry Eppley

World-Renowned Plastic Surgeon