Q: Dr. Eppley, I had a sliding genioplasty after I had braces for 2 years to fix my bite. I thought my chin was large and I wanted it reduced. I did not like the results. I felt like my face looked fatter and as though there is extra tissue/bone under my chin. My oral maxillofacial surgeon told me that if he removed the screws and plate from the previous surgery it would not make my chin look as big and I thought he was going to shave off the bottom part of my chin that appears to stick out but the only thing he did was remove the one screw as he said he couldn’t remove the other one. My chin looks very asymmetric to me and there are indentations and lines that I do not like. I was wondering what your opinion is and if there are any options to improve my appearance. I have more pictures I could send if it would be helpful. Thanks!
A: Thank you for your inquiry. I suspect you originally had a reverse sliding genioplasty to fix a protruding or big chin. This operation is always never a good idea because even though the horizontal projection of the chin may be less, the chin will look wider in the front view and a bulge or increased fullness will occur under the chin. These are the exact symptoms that you developed after your sliding genioplasty. While your surgeon meant well, removing the fixation hardware would not have made any difference in how it looks even if all the plates and screws could be removed.
While I would need to see your after surgery x-rays, the correct treatment now is a submental chin reduction approach to vertically shorten and narrow its width. At the same time, liposuction and a submental tuck needs to be done to smooth out the contour under the chin.
Dr. Barry Eppley