Do I Need Jaw Advancement Or A Sliding Genioplasty?

Q: Dr. Eppley, Which is better for me, jaw advancement or a sliding genioplasty. I think my whole lower jaw is short and needs to be brought forward. I have attached some view pictures of my ideal result and an x-ray of my jaws from the side view. Can you tell me what I really need to give my face/lower jaw a better profile?

A: What you have is a classic Class malocclusion/dental relationship which accounts for the retrognathic lower facial profile and the associated soft tissues effects. A sagittal split mandibular osteotomy would be the ideal procedure which requires some preoperative orthodontic preparation. (as the amount of forward jaw movement is completely controlled by how the teeth fit together afterwards. Whether the amount of forward jaw movement would create the profile change you have shown would have to be determined by preoperative cephalometric tracings.It is possible that a small sliding genioplasty movement may be needed with it as well. But this can not yet be determined until the orthodontics have you prepared for surgery.

If orthodontics are not in the plan, then an isolated sliding genioplasty would need to be done to create the bony chin and profile change. Moving the whole mandible is skeletally better (as it moves the teeth and lower lip forward as well but that completely depends on orthodontic preparation.

Dr. Barry Eppley

Indianapolis, Indiana