Should I Have A Second Sliding Genioplasty To Get Even More Horizontal Chin Projection?

Q: Dr. Eppley, earlier this year I had a forward-sliding Genioplasty. Myself and the surgeon had agreed on a projection of 8mm, but during the operation the surgeon decided that 6mm would be better. I wasn’t convinced by this decision at the time of leaving the hospital and I’m still not convinced now. 

To be fair, I can see a positive difference which is wonderful! However, I still believe that 8mm would have been the better choice and I’m overall disappointed by what could have been. What do you suggest I do next, if anything at all? I would very much appreciate your professional opinion. Kind Regards, 

A: Thank you for your inquiry and sending your before and after pictures. I can appreciate your sentiment that 8mms was a good choice for advancement given the amount of natural chin recession you had. While not achieving the ideal chin augmentation goal there is some solace when the operation goes on to heal uneventfully. Presuming your interest is in improving the result you have (which is what you are exploring) one ‘advantage’ of the prior surgery is that you have a very clear idea as to what 6mms achieved. That then allows you to re-evaluate the original premise of whether 8mms was the ideal choice or perhaps even more would be better. With the new number in mind your options are obvious to re-do the sliding genioplasty or top it off by adding a small chin implant on the front end of it. I can make arguments either way but at an added augmentation of 2mm to 4mms at most, adding a chin implant on the front of it seems an acceptable choice given the reduced magnitude of the surgery. But I have seen plenty of patients make similar movements by re-doing the sliding genioplasty as they were strongly opposed to an implant. There is no right or wrong about either option, it is all about whatever makes the patient feel most comfortable.

Dr. Barry Eppley

Indianapolis, Indiana