Chin Recession Surgery

Q: Dr. Eppley, I’m concerned with my severe chin recession. Although in the attached photo I think I might have slightly tucked my jaw in my neck, it appears like I have a very full neck and almost a double chin. It really doesn’t have to do with body fat since I’m almost underweight at 130 lbs considering I’m 5’10” tall. After some research, I found that my particular neck appearance is due to the anatomy of the surrounding neck muscles and the hyoid bone. I’m also attaching a lateral X-Ray cephalogram in case it’s helpful to determine anything related to anatomy.

Is the image morphing that I have attached any realistic? I’ve thought of four possible routes to come close to it :

1) Sliding genioplasty combined with submentoplasty for a better cervicomental angle
2) A custom jawline implant designed to posteriorly extend the jaw as much as possible
3) Sliding genioplasty + custom jawline implant + submentoplasty
4) Lower jaw advancement surgery (BSSRO) , though I’m not sure if I am a candidate for it since my bite seems normal -except an overjet I have-
What do you think would be the best route for my goals? Feel free to do your own imaging if you think mine is not realistic.

A: The answer to your chin recession surgery and neck issues is #2, a custom jawline implant. Besides the fact that it would most likely resemble the computer imaging you have done, it provides a recruitment of tissue from the neck to create the definition along the jawline. Options #3 and 4 are not viable approaches for you for a variety of reasons. Your choice really comes down #1 and #2. The problem with #1 is that a sliding genioplasty will have no impact behind the chin and will make the chin more narrow from the front view.

Dr. Barry Eppley
Indianapolis, Indiana