How Can I Avoid Vertical Lengthening In A Sliding Genioplasty?
Q: Dr. Eppley, I’m planning to have a sliding genioplasty, I have a recessed chin and a bit of asymmetry. I’m afraid doing it and my front face will be to long, a dr told me I need a 6mm advancement and I told him about the asymmetry he says he cant see it, What do you recommend about the asymmetry and the front face being long?
A: If the preoperative concern is that any vertical lengthening will occur as the chin is brought forward then you plan on shortening the length of the chin bone as it comes forward. That is done by tilting the fixation plate to allow for some vertical shortening.
If you look for your chin asymmetry it is easy to see that really the two sides of the jaws are different. Many chin asymmetries are not just isolated to the chin but are due to differences in the two sides of the jawlines. While subtle it is nonetheless present and if the patient sees it before surgery they will most certainly see it after surgery if unaddressed and may likely appear worse. The chin asymmetry appears to be that the left side is a bit more recessed than the right and may be higher as well. Rather than just guess or ‘eyeball’ how to set the chin bone in its new position a 3D CT scan of the lower face should be done to better understand how to rotate the chin accordingly to account for the pre-existing asymmetry
Dr. Barry Eppley