Can Subtotal V Line Reversal Be Done?

Q: Dr. Eppley, Currently I have questions about whether or not  revision work can be performed on me – specifically if a reverse sliding genioplasty along with a vertical chin length reduction and jaw implants is possible. I had Vline surgery and a sliding genioplasty done 2 months ago and despite not being fully recovered (knowing that ideally I need to wait 10 months before I have another correctional surgery), I am not happy with the results as my surgeon did not listen to what I had wanted during my consultations. The surgeons technique and results are not botched on a technical standpoint but aesthetically it is not what I wanted and it is causing me a lot of mental destress. My surgeon did not reduce the length of my chin vertically at all but rather reduced the width of my face and gave me a sliding genioplasty. I did not need the sliding genioplasty and I believe it’s making my face/chin appear longer in tandem with my overall jaw width reduction. I miss having more width to my face. I am very distressed about my current facial contouring results and I am hoping to get my self confidence and life subsequently back! 

A:Thank you for sending your pictures and x-rays. Like many patients who feel they have an overcorrection from their V line surgery, what you would have felt better about is if you have half the V line reduction that was performed. (but that is not how V line surgery can be done…it is a radical procedure where the intraoral access only allows a lot of jaw angle bone removal)  Custom jawline implants can help restore some of that missing bone…a subtotal V line reversal) From the chin standpoint you had a classic t-shaped genioplasty where the width of the chin was reduced. This is not a sliding genioplasty per se, it is the typical chin procedure that is commonly done in V line surgery. Not height reduction or increased forward projection was done. The height of the chin can be reduced secondarily as a vertical reduction genioplasty.

Dr. Barry Eppley

World-Renowned Plastic Surgeon