Should I Get A Revisional Sliding Geniplasty Or A Chin Implant?

Q: Dr. Eppley, About two years ago, due to some teeth maloccIusion, I underwent a maxillofacial surgery, specifically a sagittal osteotomy and a Le Fort 1 osteotomy, combined with a sliding genioplasty. As you may notice in the followed x-rays, my lower maxilla is still recessed, which is the object of my present message. 

I consulted with a surgeon which, without seeing the x-rays (they were not at my disposal at this given instance), suggested me a profiloplasty, precisely a rhinoplasty associated with the placing of a two-piece Medpor chin implant.

However, after observing my chin’s inclined tip on the x-ray, I am concerned that an implant would not give the best forward projection and I wonder whether there would be a better option (revisional genioplasty ?) you would suggest or on the contrary you would advise me to opt for the Medpor implant. 

A: It is difficult to give an opinion just based on x-ray alone. It all depends on how far forward the chin need to be augmented as well as what does the chin look like now from the frontal view. Do you care if the chin becomes more narrow as it comes forward or do you prefer it to get wider as it comes forward? You have to have a clear 3D concept of the dimensions you need to change from which the best chin procedure can be selected for it.

Dr. Barry Eppley

Indianapolis, Indiana