How Can I Reduce My Overprojected Sliding Genioplasty?

Q: Dr. Eppley, I’ve found your work and I’d like to inquire about a consultation about a reduction genioplasty. I had double jaw surgery to correct a class 3 underbite in 2015 and since then have had no problems, except aesthetically I do not think the position of the chin highlights my improved bite. I would like to discuss what reduction and shaping would entail. I am a professional musician- I play the clarinet. So this is a high consideration for me and it’s important that I make an informed decision. Hope to hear back soon.

A:Thank you for your inquiry, detailing your prior surgical history and sending your pictures. I can certainly see based on your profile picture of your interest in a reduction genioplasty. I can also see in your x-ray that you had an advancement genioplasty which I presume was done with your double jaw surgery. I don’t know the logic of why that was done at your double jaw surgery, particularly when it was for a class III malocclusion in  a female, but now it is an unfortunate over augmented chin.

In considering bony reduction sliding genioplasty there are two concepts about yours that I know for certain. First in general an intraoral sliding genioplasty reversal is usually a poor aesthetic procedure in that it creates a redundant submental soft tissue problem. Second as a professional musician in which lip sensation and lip competence is critical I would consider any intraoral chin procedure very cautiously. For these two reasons this is not a good approach to your chin reduction and I wouldn’t do it. The  more appropriate approach is that of a submental one where both the bony chin reduction and the resultant soft tissue excess will result can be simultaneously addressed. This is not only the better aesthetic procedure for pure horizontal chin excess but also avoids much of the potential lip issues which are so critical to your profession.

Dr. Barry Eppley

Plastic Surgeon