Sliding Genioplasty

Q: Dr. Eppley, I am a 21 year old college student. I’ve always been conscious about my side-profile, specifically the chin area being weak, and was thinking about pursuing a chin implant. In addition to whether you think a chin implant is appropriate, I was hoping you might be able to tell me with you expertise whether a chin implant would help reduce mentalis muscle strain or the dimple that appears from holding my bottom lip up when my mouth is mostly at rest. I have read online that it should, but have received mixed/unsure messages at consultations in my local area. In other words, I would like to have a smooth chin line at rest following the strengthening of the profile. Thanks!

A: Thank you for your inquiry and sending your pictures. A chin implant is exactly what you should NOT do. That is the wrong treatment strategy for your jaw problem. You have a very horizontally short and vertically long chin which is associated with lower lip incompetence and a mentalis strain. The correct treatment choices are either orthognathic surgery (braces and move the entire lower jaw forward) or a sliding genioplasty.

Assuming you do not want to change your bite, a sliding genioplasty moves the chin bone forward with vertical shortening AND improves lower lip competence and the mentalis strain. It is probably a fairly big movement (10 to 12mm maybe more) but a chin implant offer none of these important functional improvements.

Dr. Barry Eppley

Indianapolis, Indiana