Q: Dr. Eppley, I am interested in a sliding genioplasty to correct my weak chin and create a longer jawline. I have fullness at my lower half of the jaw which is actually bone even though it looks like jowls. I have a bone notch half way down my jaw where the bone comes out so the jaw looks fuller and looks too masculine for my liking from the front. I’m not sure where the cut from a sliding genioplasty is but if it is quite far forward so this part of the jaw can be shaved down a bit in addition to moving my chin?
A: Your question is a good one as it relates to the width of the jaw behind the chin where the location of the sliding genioplasty is performed. The bone notch to which you refer is actually normal and is known as the antegonial notch. As the jaw bone descends from that area it can sometimes get a little wider. Whether it can be safely reduced depends on the exact location of the width and its relationship to the mental nerve from the bone which exits somewhere close to that area. While to may be aesthetically desired to reduce it you also don’t what to potentially cause permanent numbness to your lower lip and chin either. The bone cut from a sliding genioplasty is a horizontal one and usually goes back behind the location of the nerve. This bone segment moving usually creates a more narrowing effect to the jawline as it becomes longer. In some cases it may be possible to reduce some of the bone behind it but if I think that the mental nerve is at risk for injury I won’t do it. It all depends on where your mental nerve comes out of the bone in relationship to this area of bone width.
Dr. Barry Eppley