Secondary Sliding Genioplasty and Soft Tissue Changes
Q: Dr. Eppley, I’ve already had a 6mm sliding genioplasty in the past so this would be my 2nd genioplasty, effectively making it a 12mm chin advancement. I saw a statement online and I’d like to know if there’s any truth to it.
“Bony changes and skin surface changes are not the same with sliding genioplasty. It is possible to advance the the bone over 10 mms but the skin surface changes are typically 1:1 up to 8mms then about 1:0.6 beyond 8mms advancement.”
Also, some surgeons say beyond 8mm, the step-off becomes apparent.
Thank you very much, Doctor Eppley. Your insight is always very helpful.
A: I would not read too much into those soft tissue change opinions about a secondary sliding genioplasty. While it is probably true that the greater the chin bone is brought forward the soft tissue thins a bit so the changes are not 1:1 at larger augmentations. But at the clinical level this is not really very relevant and would not factor into how the genioplasty procedure was done.
The bigger the horizontal chin advancement the bigger the step off can be. But in a ‘staged’ sliding genioplasty I am to sure now relevant the step off concern is.
Dr. Barry Eppley