Q: Dr. Eppley, I’m contacting you because I believe you may be able to offer some advice on my sliding genioplasty procedure.I recently went through with a revision genioplasty and I am currently recovering, it has been 1 week since the surgery. The surgery went well however I am concerned and merely certain that my surgeon did not move the chin forward enough to truly support the loose skin on my chin and the mentalis muscle. I specifically asked him to put the chin back in the same position that it was in prior to any revisions and I provided numerous X-rays and pictures, however I can see and feel that it’s not in that position. I raised my concerns to him but they are telling me to give it more time because it’s swollen and I cannot tell the final result right now.
I am aware that it is swollen, and I do have a follow up visit on Tuesday with the doctor where x-rays will be done. If I find for certain in the x-rays that the chin position is still off from the desired projection to support the mentalis muscle, what do you think is the best way to proceed forward to revise it? I would really like to get it revised immediately before the bone starts to heal back up. I’m just not sure about how to go about requesting this from the doctor and avoiding additional fees. My surgeon clearly mentioned that his precision will be within half a millimeter of the desired outcome. I’m concerned that it’s not but I do not know if I will be able to get them to correct it even if the X-rays prove that it’s further off. I believe it is about 2 millimeters from the projection of the original position but another issue is that I can feel that the chin bone points slightly up instead of down which would be inline with the rest of my jaw. A simple 2 millimeter plate increase seems like it will fix the angle and projection issue.
I understand that some of these questions don’t really have direct answers, but if you can offer me some advice/recommendations, that will be useful.
Also I’m wondering, if the doctor agrees to increase the projection and the surgery is done within say 3 weeks of this original surgery, do you think it would be possible to do it under local anesthesia? I’m wondering because it seems like it would be a easy procedure as no bone cutting should be necessary and just exchanging the plate size should suffice.
Thank you for your time, I will look forward to your response.
A: Thank you for the detailed information on your recent sliding genioplasty surgery. However I do not provide advice or recommendations on patients who are under the active care of another physician. That would be inappropriate as I can only comment on what I would do, not what another surgeon would or should do. Your questions are best handled by addressing then directly with your surgeon who I am sure would appreciate that you are having that discussion with him.
Dr. Barry Eppley