How Can The Bony Stepoffs From A Prior Sliding Genioplasty Be Fixed?
Q: Dr. Eppley, I have two large dents (step-offs) and a large bony bulge (on left jawline) that resulted from a bad sliding genioplasty done in 2009. I just want my straight jawline back but concerns over someone not experienced in bone work, particularly in what I’ve been told is a complicated repair, have resulted in my waiting years. However, it’s time to do something and from what I’ve seen and read of your work you have performed these types of repairs before. I have pictures that will show the deformities and happy to send. Would you be willing to discuss my situation? Thank you very much for your time.
A: A 3D CT scan is needed to have an accurate assessment of both the bony stepoffs and the bony bulge. I suspect the bony bulge is due to a shift of the sliding genioplasty resulting in one wing that sticks out. This also contributes to a larger bony step off on the opposite side than would otherwise exist. This would ned to be burred down. The bony setoffs from a sliding genioplasty can be treated with an overlay implant. For the sake of absolute accuracy I would prefer to make custom implants to fill in the defects which can be designed off of your 3D CT scan.
Dr. Barry Eppley