Vertical Chin Lengthening

Q: Dr. Eppley, I am interested in chin (vertical chin lengthening)  and jaw augmentation surgery, particularly, adding vertical length by means of a sliding genioplasty. I have an overbite, however, I consciously usually just move my jaw forward so that is is properly aligned so I have included 3 pictures in which you can see the overbite and 3 pictures in which my jaw is in a normal position.  My goal is to increase vertical length of my chin/jaw and perhaps add an appropriate amount of horizontal projection in order to have a more square jaw appearance as well as a less rounded face look.  In terms of how many millimeters can be added vertically, about how many mms do you think would be possible or how many would you suggest?

A:Thank you for sending your pictures and doing the ‘surgical simulation.’ By moving your jaw forward you are creating a surgical type result of the chin through vertical chin lengthening. That would be the approximate effect on the appearance of the chin as moving the jaw forward provides a vertical chin lengthening. The amount the chin should be vertically opened is determined before surgery by measuring the distances between the upper and lower teeth as you go from having them together to the desired position of the jaw that creates the look you like. In most cases of vertical chin lengthening it is usually about 8 to 10mm of opening the chin osteotomy centrally to see a very noticeable chin appearance change in my experience. Two caveats about vertical chin lengthening and its effects on the appearance of the jawline. First it will not make the chin more square since it is just the natural chin shape that is being moved forward. Second, the appearance of the jawline will not change like it does when you bring your jaw down and forward too simulate the effect of vertical chin lengthening. Such a maneuver moves the entire jaw down which is not creates when you surgically just vertically length the chin.

Dr. Barry Eppley
Indianapolis, Indiana