Can I Achieve My Ideal Chin Augmentation Goal With A Sliding Genioplasty?
Q: Dr. Eppley, My goal is to have a more defined long term, permanent chin. In which case my chin would align with my upper lip and or nose as it should. In most cases my side profile looks like a straight slope and no chin. The TMJ clinic believes it is not in my best interest to have a foreign body implanted due to my past history of JIA. It seems as though a plate and screws that would be used for a sliding genioplasty is not a foreign body, which I do not entirely understand. They are unable to say for certain exactly how much they may be able to extend my chin with a sliding genioplasty and I am concerned if I go through the surgery and the chin is not slid forward enough for the look I’m wanting, it would be a waste of money and unneccessary risk with my JIA. They are unable to do a picture of what it should look like upon completion to help with my decision. I would like to know if you believe I can accomplish the look I’m wanting with merely a sliding genioplasty since I am unable to go forward with an implant for health risks and reasons.
A: Having treated numerous extremely short chin patients, including RA patients, the first thing you have to realize is the magnitude of your chin deficiency…which is really a jaw growth deficiency of which the chin is but a symptom of it. Avoiding an implant in such a short chin is a good thing even if you didn’t have RA so a sliding genioplasty is the correct procedure for you. Secondly the actual measured chin deficiency, as defined by your own goal of bringing the chin out to a vertical line dropped down from the lip is probably in the range of 25mms or an inch. The sliding genioplasty is based on moving the entire thickness of the chin bone forward. In your case you need what is known as a ‘jumping genioplasty’…which means putting the entire thickness of the lower chin bone in front of the bone above it as opposed to a traditional sliding genioplasty which just pushes it forward along the cut line. (this also prevents the chin from getting vertically longer) This is what I do in cases of extremely short chins. But even with this procedure the amount of forward chin advancement is limited to the thickness of the bone which is probably in the 10 to 15 mm range.
This is the anatomic explanation for why your ideal result can not be achieved as you have imaged it as it is beyond what the bone thickness will allow. More achievable is a 50% to 75% amount of what you have imaged.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
North Meridian Medical Building
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