How Do I Get A Little More Horizontal Chin Projection After A Sliding Genioplasty?

Q: Dr. Eppley, I am a 40 year old female born with a weak chin. I had a chin implant placed ten years ago, which was removed 2 or 3 months later. I waited for another year to get a sliding genioplasty to pull my chin forward.

What I DO like about my current chin:

1height and width from front view. I think it’s proportionate to my face. I don’t want my face to be any longer or my chin to be more pointier.

What I DO NOT like about it:

1From side view, it’s apparent that it’s still a little recessed.

2Slight asymmetry and irregularity. It seems that there is a “ball” or soft tissue sag underneath. I am hoping to “tuck in” the chin and increase the horizontal projection by 3 or 4 mm.

I wonder if you would recommend another chin implant or a revised sliding genioplasty? 

Thank you very much!

A: Thank you for your inquiry and sending your pictures. Since you like the current height and width of your chin, it would be hard to justify a repeat sliding genioplasty for a 3 to 4mm horizontal increase. (unless you are opposed to an implant) Thus a small anatomic chin implant can be used with the only debate as to whether this is placed intraorally or from below.

The other issue of irregularity and asymmetry of the chin has to do with the prior sliding genioplasty in how the bone was set into position and how the overlying soft tissues have adapted to the advanced chin bone. This is probably not completely correctable by adding an implant onto the chin bone unless a custom designed chin implant was used. (which I don’t think you can justify the cost for that type of modest improvement)

If the chin implant is put in from underneath such access provides the opportunity to ‘tuck in’ the overhanging/redundant soft tissues.

Dr. Barry Eppley

Indianapolis, Indiana