How Soon Can A Secondary Sliding Genioplasty Be Done?
Q: Dr. Eppley, Hello, I had a sliding geniolplasty of 8mm forward and 4mm vertical increase 6 weeks ago. I absolutely hate how it has made my chin pointy and my face too long. I believe an advancement of 5-6mm initially would have been perfect. I would like to know what the differences are beween a primary and secondary genioplasty, and how accurate a second procedure would be as well as the risks/complications. Will the skin sag/ change? Will the bone heal completely after a second procedure? Is there any reason to have it done sooner rather than later or vice versa or not at all? Would decreasing the vertical height by 3mm and forward projection 2mm be sufficient? I’m sorry I have a lot of questions as I am incredibly depressed at my current look as I had a really nice face before and have made it worse. If you could help me with these questions I would be more grateful than you could ever know.
A: In answer to your secondary sliding genioplasty questions:
1) You perform a secondary sliding genioplasty to change the chin bone position when you are certain you are looking at close to the final result and you know what specific dimensional changes need to be done to make it look better. Usually patients have as very good idea around the 6 week after surgery time period.
2) A secondary sliding genioplasty is essentially the same procedure as the first one. The same bone cut is followed as the first time. It is usually less traumatic to the patient the second time as the patient already knows what to expect.
3) The risks and complications are theoretically the same as the first time…although the aesthetic risks are less since you have a known dimensional change and you know exactly how it looks.
4) If the original movements were 8 forward and 4 down then it would seem logical that less of each would be an improvement. At the least it would seem halving each one, 4 forward and 2 down, would be a good aesthetic compromise that is more than you had initially (there is a reason you had the procedure) but less than what you know you don’t like. However I would need before and after pictures to provide a more qualified dimensional change recommendation.
5) The bone will heal just as well the second as the first time.
6) There are no concerns about loose chin tissue in a setback of this amount.
Dr. Barry Eppley