Should I have A Chin I implant or Sliding Geniplasty With My Severely Recessed Chin?
Q: Dr. Eppley, I’m a 23 yo female. I am actually quite satisfied with how I look from head on (I’ve no prior procedures). I’m dissatisfied with the slight nasal hump and nasal tip drooping, but am more concerned with the weakness of the profile of my chin.
I have considered going to local, domestic, and international surgeons. However I am fearful that I might go to someone who will not adequately address my concerns and that I will have limited improvement in my chin projection thus wasting my time and money. I’m impressed by your work and thoroughness and would rather travel to you for such an operation.
I anticipate a more aggressive approach to produce as much augmentation as possible. Potential through the use of multiple procedures/techniques. Sliding Genioplasty, Chin Implant, Custom Implant, and Chin fillers are all procedures that I’m open to. I don’t think I can make a well informed decision. I prefer an option that is permanent, offers significant projection to the chin, avoids severe labiomental fold, and that is within my budget. I will take your suggestion on what might be best.
A: In answer to your chin augmentation questions:
1) With the significant weakness of your chin you are only a candidate for a sliding genioplasty and not an implant. Your horizontal projection increase in the chin exceeds what any implant can do or the stretch of the soft tissues of the chin to accommodate that change over an implant.
2) The amount of chin bone movement you need is well into the double digits, probably in the 14 to 16mm range at least. (see attached imaging). In addition to coming that far forward it also needs to be vertically shortened to avoid making the chin longer which can inadvertently happen when that amount of chin bone advancement is done. The tightness of the soft tissues over the chin when it is moved this amount will preclude the use of a chin implant over it. That is best anyway as make your own natural tissues do all of the work of the augmentation.
3) The labiomental fold is going to get deeper which is unavoidable. That is the aesthetic tradeoff for any significant horizontal chin increase.
4) Patients coming in for surgery and traveling home is the norm in my practice, not the exception.
Dr. Barry Eppley
World-Renowned Plastic Surgeon