Does A Sliding Genioplasty Cause Less Labiomental Fold Deepening Than A Chin Implant?

Q: Dr. Eppley, I think it might be best just to ask a few questions along with a few photos for you to view. I understand a chin implant or a sliding genioplasty would highly benefit myself, although being 26 years of age, I am leaning toward a sliding genioplasty.

If I’m deemed a suitable candidate, my main concerns are: 

1) The “step off” created from moving my chin forward creating a narrow profile (sliding genioplasty), being a male with an already narrower jaw/chin a smooth tapered jaw/chin is ideal. Some surgeons use materials like Goretex to place along the chin/jaw for a nice look. What would likely be recommended in my case?

2) A unnatural labiomental fold is, this is a big concern and reason I’m looking to avoid an implant. Based on a quick assessment of my photos provided, would grafting to my labiomental fold be necessary to avoid an unnatural look? If so, what type of grafts are used?

My goal is a well balanced natural looking face with a stronger chin and jaw. 

Here are two patients of a sliding genioplasty along with my facial profiles to get a quick assessment of myself

A: Thank you for your inquiry about sliding genioplasty and sending all of your pictures to which I can say the following:

1) The deepening of the labiomental fold occurs in both implants and the sliding genioplasty. There is no difference between the two in terms of having that effect as the labiomental fold is a fixed anatomic point due to the origin of the mentalis muscle. That is not a good reason by itself to choose a sliding genioplasty.

2) The sliding genioplasty does offer the ability to manage the depth of the labiomental fold better by placing something into the anterior step-off which is either a graft or an implant. The anterior step-off is better managed by some form of a bone graft.

3) Every sliding genioplasty, by definition, creates lateral or posterior stepoffs which will narrow the chin or create indentations. That can be managed by implants of which ePTFE (what is historically known as Goretex) is one option.

4) A sliding genioplasty provides aesthetic enhancement to the chin not the jawline that is behind it. It is not a jaw enhancing procedure by the anatomic definition of the jawline.

5) Attached imaging is one flavor or degree of chin augmentation, you may prefer more for less….yet to be determined.

Dr. Barry Eppley

Indianapolis, Indiana