How Soon After My Sliding Genioplasty Can It Be Revised?

Q: Dr. Eppley, I am interested in a consultation with you regarding undergoing a possible revision sliding genioplasty.  I am 1 week s/p SG elsewhere — my surgeon reports we did a 10mm horizontal advancement. Recovery afterwards has been easy and unremarkable, but after doing comparison photos now I can see that we didn’t achieve near as much projection as we anticipated. I’m 100% aware that full results won’t be apparent for some time still, but my understanding is the horizontal projection is not going to meaningfully improve. I’ve attached a photo comparing pre, my surgeon’s prediction via morph, and now 1 week post. Any thoughts on why this may have happened? Is the predicted morph something you think you would be able to realistically achieve, and if so is it more optimal to do a revision within 6 weeks?

I am going to call your office today regarding scheduling a full consultation, but I understand it can be easier to revise an SG within 6 weeks of surgery and hence was hoping to get your input sooner if possible. I can also proceed with getting any recommended imaging sooner this way.

Greatly appreciate your time and input —

A:My first question is whether that was really a 10mm forward movement. While one can debate about how much forward movement the morph actually is (looks somewhere in the 10 -14mm range) your one week after surgery picture (which would have some swelling) doesn’t look anything like a 10mm movement to me. That doesn’t mean it wasn’t (I wasn’t there) but that is not what I would think a 10mm advancement would do at one week postop. The absolute way to know is a lateral cephalometric x-ray. To some degree how much movement was done is somewhat irrelevant as no matter what it was it was not enough. It clearly needs to be double what was done.

Dr. Barry Eppley

World-Renowned Plastic Surgeon