Is A Chin Implant Or A Sliding Genioplasty Better For Improving My Double Chin?

Q: Dr. Eppley, I have been struggling with my double chin for many years. I had Cool Sculpting done twice to my chin. After the results didn’t work to get rid of my double chin. I went to see a plastic surgeon for chin liposuction. He told me I don’t need chin liposuction and instead need a neck lift or skin tightening treatments. This year I did Venus legacy radiofrequency treatments which didn’t solve the issue. It’s not until I started going to consultations with orthodontists that I found out that I have overbite and overjet with recessed lower jaw and small chin. I was told I’m not a candidate for lower jaw surgery due to extractions I had as a child and has recommended genioplasty. I read up on sliding genioplasty procedures and discussions about it on forums and the thought of such an invasive surgery discourages me. Could my issue be resolved with an extended chin implant? I have attached photos of my lower jaw at rest and then moved forward slightly, approximately 5 mms., If you could kindly provide your professional advice via e-mail I would greatly appreciate it. 

Thank you.

A: Battling a double chin in the face of a skeletally short lower jaw using a soft tissue approach only is always a losing proposition. You have struck upon the key element of the solution to your double chin which is either lower jaw or chin advancement. A chin implant will not improve your neck, only the chin projection. Bringing the chin bone forward is the proper and only solution as that pulls the submental muscles and tissues forward with it. What you have is what I call the ‘accordion’ neck. The tissues are bunched up because the bone that partially supports them needs to be stretched out.

I suspect that a 5mm sliding genioplasty advancement is too little (7 or 8mms would be better) but that is a minor issue compared to the overall concept that you would get the most benefit from a sliding genioplasty procedure. While the providers you have seen to date did not make that diagnosis from the beginning is a mystery to me. This is basic understanding of neck and jaw anatomy.

Dr. Barry Eppley

Indianapolis, Indiana