Can My Sliding Genioplasty Be Vertically Shortened?

Q: Dr. Eppley, I am one month post-op from a v-line jaw reduction and sliding genioplasty. Although I am well aware that I am not at my final result due to swelling, observing through my x-rays I can confirm that my chin has actually increased in vertical length when I desperately wanted the opposite. My surgeon is unfortunately non-responsive. My question is, is there any way I could undergo a revision sometime in the next month since the detached part of my chin that is secured with screws is entirely the length of bone that I would like to have removed? I have linked my post-op x-ray with a photoshopped x-ray of what my desired results are to clarify what I am trying to express. Thank you so much for your time!

A: It appears that you have had a set back sliding genioplasty from your x-ray. The severe angle of the bone cut makes vertical lengthening occur when the downfractured bone segment is slide backward. To effect that degree of vertical shortening that you want, you would take out a wedge of bone from above the cut and bring the lower segment up to it. You can not just remove the bottom segment because the muscular and soft tissue attachments to the chin bone would be lost resulting in significant chin and neck soft tissue sag. Given that you have not had any bony healing from your prior sliding genioplasty, you should have such a revision in the next few weeks or month.

Dr. Barry Eppley

Indianapolis, Indiana