How Can My Sliding Genioplasty Dents Be Fixed?

Q: Dr. Eppley, I had a 6mm genioplasty but i dont like how it brought out the imperfections in my jawline. My side profile looks good and overall an improvement, but my chin is naturally weirdly shaped and my mandibles are inward so my jawline is not smooth. I want to look into maybe moving the genioplasty back 3mm and getting a custom jaw implant to make my chin more symmetric and smooth, as well as my mandible and full jawline.

A: What you have is a very common sequelae from sliding genioplasty which is a natural result of the geometric shape change at the front of the lower jaw. As the chin is brought forward the wider U-shape of the chin can develop a more pinched shape at the back end of the osteotomy lines. While his usually does not occur at just a 6mm bone advancement it can if the osteotomy lines are significantly angulated.

There are two approaches to smoothing out the existing inferior border indentations at the back end of the sliding genioplasty osteotomy lines. While certainly the sliding genioplasty can be reversed that would throw away any of the good aesthetic improvements you have obtained from the initial surgery. The alternative approach is to fill in the bony indentation which can be done by a variety of materials from standard ePTFE sheets to small custom interior border implants. (lateral chin implants)