Should I Have Orthognathic Surgery Or Chin Augmentation?

Q: Dr. Eppley, I have a couple follow up questions regarding both the picture and the operations itself.

1) I’m a little confused by these pictures without labels, is the first one the 8mm advancement and the 2nd one the 12mm? The one that was sent over last thursday was for the 10mm? If that is the case, can I have the front view for the 10mm as Dr. Eppley only did a side view for me for that one.

2) Dr. Eppley mentioned that I have deficient lower jaw growth, which leads me to think that jaw surgery may be an option. I currently do not have any severe jaw related problems (sleep apnea etc. though I do snore quite loud sometimes). What is the aesthetic difference between the jaw surgery and the sliding genioplasty that he recommended? My logic goes like this: If there is indeed no aesthetic difference between the two, then why waste the time and effort to go through Jaw surgery? Are there any additional benefits for me to go consult with a jaw surgeon rather than go through with the sliding genioplasty, with the latter being much more cost effective. What are your thoughts for my case?

3) Given my deficient lower jaw, will the sliding genioplasty accentuate that? In other words, will the lack of a lower jaw become more pronounced after the surgery?

A: In answer to your questions:

1) the pictures are label as pred 1, 2 and 3 in their tags which signify roughly 8, 10 and 12mm horizontal movements.

2) Unlike the profile view, front view imaging can not be predicted based on millimeter movements.

3) Whether orthognathic surgery is an option depends on the state of your occlusion. (bite) If there is no functional bite issues or the bite discrepancy is slight/modest, then orthognathic surgery is probably not an option. But without x-rays, a bite analysis and an orthodontic evaluation the merits or lack of merit to orthognathic surgery can not be precisely known based on external facial pictures. The only definitive way to address this issue, one way or the other, is to get a formal evaluation/workup for it.

4) I would go by what the pictures show you and the effects of the chin augmentation change about its effect on the rest of the lower face/jaw.

Dr. Barry Eppley

Indianapolis, Indiana