Is A Sliding Genioplasty Right for Me?

Q: Dr. Eppley, I have an overbite that I’ve been told (by a couple of orthodontists) can only be fixed with jaw surgery.  And due to the overbite I have a pretty recessed chin and my nose appears bigger.

However, jaw surgery is a major surgery and I don’t have the type of support system needed to help me with the length of recovery required.  Also, it would take a long time before I could even have the surgery because of braces, etc.

So I’ve decided to instead check into improving the cosmetic aspects of my recessed chin for now instead of the underlying problem.  I’m thinking a sliding genioplasty would help a lot.  Maybe I would need an implant too.  But that is what I am contacting you for, to find out what you recommend.  My nose might still be proportionately too big also, even after improving my chin.

When I was younger I found a plastic surgeon and had a chin implant and rhinoplasty.  This was before the internet and I really didn’t know what I was doing. I had never heard of sliding genioplasty. The surgery did result in an improvement, but really not a big change. 

I’ve seen before and after photos from you and other surgeons for sliding genioplasties, and they are amazing!  It wouldn’t address my underlying problem, but it would make my profile look so much better! 

I also don’t like the size of my nose but I don’t know how it would look if my chin looked better.  And I’m noticing my face getting a little saggy around my mouth/chin due to age, but maybe the chin surgery would make that less noticeable?

Anyway, I would love to know what you recommend.  Attached are some pictures I took as well as a x-ray from my more recent orthodontist.

A: Thank you for your inquiry and sending your pictures and x-rays. As you know you have an entire short lower jaw and Class II occlusions for which jaw advancement surgery is ideal…but we know the effort to do that at this point in your life is not acceptable. Thus a sliding genioplasty is the procedure you need for cosmetic camouflage because you have both a horizontally and vertically short chin for which an implant does not do well for those combined movements. (the chin implant you have is very small and is positioned too high to have much of an effect) I have done some imaging looking at bony chin movements of 7mm forward and about 5mm vertical as a starting point. While this will help with some of the loose tissue under the chin , the submental area should be ideally treated with liposuction at the same time for best contouring. By the imaging you can see that the nose looks smaller as the lower face comes into better balance. But I also did some imaging looking at nasal tip reduction as well for you to see the combined effect.

Dr. Barry Eppley

Indianapolis, Indiana