How Do You Recommend To Revise My Previous Sliding Genioplasty?

Q: Dr. Eppley, I had a genioplasty along with double jaw surgery 2 months ago, the chin was cut in a way so as to make it narrower (although my chin wasn’t wide at all it was already narrow and feminine) and was increased 10mm horizontally and 15mm vertically. The chin looks very very pointy now, as there is almost no width left and it further sticks out because of the intentional 15mm increase which in my opinion was a bit too much. The surgeon at first only said that I will take it back after a few months and now has denied and is insisting on plate removal. I’ve talked to another surgeon who hasn’t told me his plan yet, I’ll have to physically go to his place and ask, but he said to come as soon as possible. My requirement is to get my lower third to be more angular again. The width of the chin can not be increased now, but I’m hoping that reducing it vertically about 8 to 10mm should make it look much better. I know the measurement 10mm in vertical reduction is quite huge but I’m afraid that without that much reduction the chin will not look good at all. My chin is sticking out from the rest of the jaw and has very very less width, almost none. I also plan to take it back slightly by 3mm or so. I’d be really grateful if you could tell me if it’s possible and advisable to reduce 10mm vertically, and also, when it should be done. I’m 2 months out of my surgery and I am sure that even if the other issues, like the pain in chin and the rolled-in lip, might get resolved in coming months, despite that I will be going for a vertical reduction of the chin as my face looks too long and the chin looks very very pointy and is not going with my wide face. I’m worried about getting saggy skin after the reduction and also any other complications that may arise with a revision genioplasty. Please suggest me the best option and also when to go for the revision.

A: Certainly a 10mm horizonal advancement and 15mm vertical lengthening is going to make any chin more pointy…which would be even more emphasized if narrowing was done as well. In my opinion you do a revision when you are certain that the desired changes is not the desired result AND you have a clear plan as to what type of revision would be beneficial. Without seeing before and after pictures and x-rays I can not make any further constructive and informed commentary about how to improve your current chin situation.

Dr. Barry Eppley

Indianapolis, Indiana