For A Secondary Chin Setback Should I Partially Undo The Sliding Genioplasty Or Shave The Bone?

Q: Dr. Eppley, Hi I had a genioplasty back in 2019 in which the chin was advanced 8-12mm. In 2022 I began gender transition. In 2024 I underwent facial feminization surgery in which the surgeon went through the mouth again to do jaw contouring to resolve the step deformity that was created by the genioplasty. The surgeon who did the FFS was resistant to reversing the genioplasty or shaving the chin back because he aesthetically felt it looked best where it is positioned post-geniopalsty. However, I continue to experience dysphoria and dissatisfaction because of the boniness the projection adds to my face. I am interested in either reversing or shaving back the chin about 4-6mm.

A:I see no reason why your chin projection could not be reduced. To reduce it by shaving as, whether one is that a prior genioplasty or not that always results in chin pad ptosis. In the genioplasty patient that risk would be even higher than normal. Therefore the correct procedure would be a setback bony genioplasty where the risk of chain pad ptosis is more limited. The other question given your FFS history is whether during your setback the width of the chin should be reduced as well in a T-shaped bony genioplasty.

Dr. Barry Eppley

World-Renowned Plastic Surgeon