Can A Vertical Lengthening Bony Genioplasty Also Correct Any Chin Asymmetries?
Q: Dr. Eppley, Regarding the surgery itself, if there are any current asymmetries in my chin, can they be corrected with this surgery, or would that require an implant?
⁃ Can any width be added to the chin with this surgery, or would that too require an implant?
⁃ Lastly, one of my main objectives is to fill/flatten the labiomental fold as much as possible, so I just want to make sure our current plan is going to achieve this. I’ve read that a bone graft is often used to fill in the fold, but I’m not sure if this would be a separate graft from the one we’ll already be using to achieve the vertical lengthening and lateral projection, or if the same graft will achieve all of the above.
A: In answer to your chin reshaping questions:
1) I am not sure what chin asymmetries they are as I can’t see them but any improvement in them from a vertical lengthening bony genioplasty would be a bonus not an expectation from the procedure.
2) While chin widths can be added to certain bony genioplasties (midline split and graft), I would be cautious about doing that to a vertical lengthening genioplasty due to the risks of instability and devascularization of the bone. That can either be done by adding on a implant at the time of the bony genioplasty or have it done secondarily.
3) By definition when you pull down on the chin (vertical lengthening) the labiomental creases unfolds and becomes less deep due to the stretch of the soft tissue chin pad. The bone graft fills the bony gap created by the vertical lengthening, it does not directly augment or push out the labiomental fold.
Dr. Barry Eppley