Maximal Chin Advancement
Q: Dr. Eppley, My overbite is mild and my maxilla and lips are already well positioned, so I’m not really interested in orthognathic surgery since it would only be serving the purpose of chin advancement.
What is the maximum anterior chin advancement one could achieve without a BSSO? Could a double-step genioplasty be combined with either a chin implant or custom wraparound jawline implant to exceed 20 mm of advancement? What factors would determine the patient’s limit?
A: Chin augmentations using a variety of techniques (bone movements with implants can get upon into the range of 15 to 18mm. But even if they could exceed 20mms the depth of the labiomental fold that would ensue as well as other chin shape issues would be the limiting aesthetic factor. Trying to achieve a chin advancement of 20mms or more is not realistic as as single stage operation due to soft tissue restrictions. I woudl focus on getting a chin advancement in the range of 12 to 15mms first using a sliding genioplasty with or without an implant and then see what you think then. Your soft tissues will be more accommodating at that amount of chin advancement.
Dr. Barry Eppley