Revision Chin Reduction
Q: Dr. Eppley,I am writing to you to enquire as to the methods one could use to restore a chin after a failed chin reduction.I underwent a chin reduction surgery to correct the excessive vertical dimension of my chin. Supposedly a section of bone was removed from the center of my chin and the lower part was moved upward. However the results were not at all as expected. My chin is now uneven in every direction, has no tip, is much too small, and has no structure to support the soft tissue around it.
I am not completely sure what the surgeon actually did. Suffice tit o say that he can not simply re-cut the line and move it back into place as the chin is now a completely different shape from what it was.
My question is; is there a method, perhaps using HA, to rebuild my chin and restore its previous shape?
A: A plain view x-ray of your chin, such as a panorex, would answer the question as to what type of chin reduction procedure you had done. Usually for a purely vertical chin reduction a wedge reduction intraoral genioplasty would be done. The results you now have do not appear to be consistent with that approach. Knowing how it was done can influence how you might reverse it or perform the revision chin reduction procedure. If it was done by a true wedge reduction vertical genbioplasty than re-opening the osteotomy site and placing an interpositional graft would work. If the bottom part of the chin was just cut off or one desires to bypass an opening wedge genioplasty then building up the bottom part of the chin bone is needed. This would not be done by using HA as getting anatomic contour and shape would be impossible with this material. Rather an implant would be designed from a 3D CT scan which would provide the optimal vertical chin shape and smoothness as well as choosing before surgery the vertical dimension increase if any is desired.
Dr. Barry Eppley