Should I Have My Sliding Genioplasty Reversed?

Q: Dr. Eppley, When I initially chose to do a genioplasty it was a decision based on genioplasty and rhinoplasties often being two procedures that complement each other. But I think because I never had any real concerns with the chin itself is the reason why I have been left disappointed with the result both from an aesthetic point of view and functional as per our earlier conversations. Moreover when I spoke with a maxillofacial surgeon at my hospital this week he said the horizontal deficiency was so minimal at baseline that a genioplasty should never have been done.

When I think back prior to having any surgeries my concerns with my face were fixated on a hooked nose from the side view and an upper/mid face that looked simultaneously angry/coarse and recessed. I’ve never been able to pin point exactly what it was that I didn’t like and I have never gone into detail about these concerns with any surgeon in the past which is why I think previous surgeries may have been premature and perhaps unnecessary.

The genioplasty was done last yeaer, and I had an open rhinoplasty done the year before. The rhinoplasty itself I think the side view is certainly an improvement from baseline however I also think it does look a bit too feminine while the front looks a bit unappealing and unnatural at the tip area.

I am wondering if we could perhaps have a detailed consultation to discuss if further surgeries are warranted (in addition to reversing the genioplasty) and if so, would this consultation perhaps best be done in person as opposed to over Skype.

My end goal is still to look like me, just a more balanced version that looks natural. I am hoping for a very honest conversation about what is in my best interest as I have worked hard to reach the career point that I am in and am a bit ashamed with myself that my body image issues have suddenly become this big of a problem for me

Attached are my preop photos before any surgeries were done and my current photos taken this week. I would appreciate any honest suggestions you may have.

A: My short comments are:

1) You have very nice results from you rhinoplasty and sliding genioplasty. I think those are very good improvements and almost all patients would be happy to have those changes.

2) The statement that your sliding genioplasty ‘should have never been done’ is completely off base and misinformed. You had a vertically and horizontally short chin for which the sliding genioplasty was a perfect treatment for that type of aesthetic chin deficiency.

3) If these type of changes are largely unsatisfactory I would be very concerned that any revision of them will end up any better.

Dr. Barry Eppley

Indianapolis, Indiana