Should I Have My Sliding Genioplasty Reversed?

Q: Dr. Eppley, I got a sliding genioplasty on July 6, 2022. Since I saw my face I thought that it looks long and I look older, also my lower lip is smaller now, it feels very tight when I talk and when I smile my face looks way longer which I hate because I used to have a very pretty and proportional smile. I talked to my surgeon and he said that the proportions are fine so I talked to another surgeon who also said that it looks great and that he would not change it because it would make more harm than good since I had the surgery not so long ago. The Dr moved 7mm and I feel like it was way too much, as a matter of fact I have cried nearly every day since I saw my face and I regret ever doing this procedure. 

I wanted to talk to you before scheduling an online appointment to know what you think. I spent extra money getting a CT scan and X rays for the other surgeon that saw me and in the end he told me he wouldn’t suggest me doing a reversal procedure. I read online that you have experience with this issue and I wanted to know what you think, if it’s possible to reverse it at least 4-5mm, how long I should wait and if you think it may have a good outcome. Thank you for reading.

A:Thank you for your inquiry and sending your pictures and x-rays. I have seen many females in your chin augmentation situation. Yes it is true that you are just two weeks out from surgery and still have a lot of swelling. But I have not yet seen a female who feels the way you do every change their perception of their result months later when all of the swelling has dissipated.

So let’s review what is relevant in your case.

1) You had a well performed and executed sliding genioplasty as per the x-ray. Thus the operation was a technical success.

2) Despite being a technical success, it was an aesthetically flawed operation as the final position of the bone was further forward than what you could aesthetically tolerate. I don’t know how the number of 7mms was chosen or the basis for it. But i would wager you were not given options before surgery using computer imaging to try and determine what looks best to you. On paper and by traditional aesthetic norms bringing your chin out to a line dropped down from the lips is supposed to be the ideal position (see attached)…but for many females with short chins that is simply too much change. Surgeons may look at it and think it is great but the patient may never really adapt to it. Usually a projection less than ‘ideal’ is really ideal for most female patients. (see attached)

3) Since there was a reason you had the original surgery reversing it completely seems counterproductive. A subtotal reversal seems more logical (e.g., 7mms back to 3 or 4) but that is a personal choice of yours.

Dr. Barry Eppley

Indianapolis, Indiana