How Can I Revise A Previous Sliding Genioplasty Reversal Procedure?

Q: Dr. Eppley, Hello, I’m interested in a genioplasty revision. To give you context, I had a genioplasty a couple of years ago where my chin was moved forward 8mm and down 3mm, about 8 months later I went in for a revision to have it reversed. The surgeon used the burring method, it’s been over a year and my chin looks bulky, flat and vertically longer than my original chin. I don’t think he did a good job, it could be excess soft tissue or maybe he didn’t reduce the bone vertically enough. This situation has been distressing to say the least. 

I think a 4 to 5mm vertical reduction will make it fit my face shape better more closely resemble my original chin. I know you are one of the few experts in this area and I would really appreciate his input and wish he can help with this.

A: Trying to reverse a sliding genioplasty is not best done by burring as, while that reduces some horizontal bone projection, it will create a definite soft tissue chin pad redundancy. Not to mention that a burring technique done intraorally can not reduce the vertical height of the chin.

To now reduce the bony height of the chin, which will further magnify the soft tissue redundancy, it may be best to take a submental approach so both vertical bone height and the soft tissue chin pad redundancy can be simultaneously addressed. 

But to provide a more informed recommendation reviewing the CBCT scan would be necessary.

Dr. Barry Eppley

Indianapolis, Indiana