How Do I Fix Chin Asymmetry After A Widening T-Shaped Sliding Genioplasty?

Q: Dr. Eppley, I had a sliding genioplasty four weeks ago. It involved a +3mm lengthening, +3mm projection, and +4mm widening. As my swelling has gone down, I realize that from a side profile view I like the lengthening and projection achieved, BUT, from the front view I see that my chin is asymmetric. I like how the left side of the chin looks, but on the right side the chin looks ‘sunken in’ – as if the bone segment were angled more inwards (and maybe upwards) in comparison to the left. The right looks ‘slimmer’ and left looks ‘fuller’ in comparison – this is something that my girlfriend and another close friend confirmed as well. It’s subtle, yet obvious. I can also feel this difference when gently running my fingers down/along the chin. Could you please advise regarding the appropriate solution, and the associated timeline? I would like to take this forward with you at the soonest. 

A:Thank you for your inquiry and sending your pictures. I believe the answer is clearly seen on your x-ray which shows the more prominent inferior border stepoff on the right side due to exactly what you have described. (see attached) Your visible and palpable symptoms match what your x-ray shows. This is a contour deformity along the right inferolateral border of the chin. There are two approaches to resolve it; 1) immediate intraoral bony adjustment to rotate the segment out and down or 2) delayed implant coverage of the bony defect, probably using ePTFE from a submental approach. Each approach has their advantages and disadvantages.

Dr. Barry Eppley

Indianapolis, Indiana