Q: Dr. Eppley, I am looking to get a sliding genioplasty in the near future. I know that both horizontal and vertical expansion can be achieved,and I am looking for both of these (very slight vertical lengthening). However, there are four other things that I am also looking to achieve and my enquiry is as to whether these can be achieved by the same sliding genioplasty procedure.
I want to widen my chin to the same width as my mouth for a masculinising effect (the distance needed is that not that large). I also want to deal with some chin asymmetry that I have. I also want to ameliorate (or at least not make worse) my mentolabial fold. Finally, I have a slightly retrusive lower lip; I was wondering whether the genioplasty would/could have any effect in bringing it forward. I realize a BSSO would be ideal, but I’m not willing to go through that so I’m going down the ‘camouflage’ route.
A: In regards to your four additional effects that you desire from a sliding genioplasty:
- While a sliding genioplasty can be cut in the middle and widened, this has limited effectiveness and should only be done by this form of bone expansion when minor widening effects are needed. A custom chin implant creates this widening effect much netter and in a more predictable fashion.
- Whether moving the bone around can improve your asymmetry depends on what type of chin asymmetry one has. You will have to be more specific as any such asymmetry is not evident in your pictures. But if the asymmetry is slight, I would not count any any type of bone movement correcting it. A sliding genioplasty can create its own asymmetries as well.
- The only way to prevent deepening of the labiomental fold with a sliding genioplasty is to graft the step-off created by the forward bone movement of the downfractured segment.
- Only a BSSO can move the lip forward since the lower lip is a tooth supported structure and not a bony one.
Dr. Barry Eppley