Sliding Genioplasty

Q: Dr. Eppley, I am interested in a sliding genioplasty for functional purposes. I am a 40 year old female with moderate obstructive sleep apnea with an AHI of 24 and 90% oxygen saturation at night while sleeping. I also have a very recessed chin and need a sliding genioplasty to both improve my obstructive sleep apnea and my cosmetic appearance. Maxillomandibular advancement osteotomies is not feasible for me. What type of sliding genioplasty is best, a mortisized genioplasty or a straight horizontal osteotomy? A craniofacial surgeon told me I need the mortisized type with a 4mm advancement.

A: I think what you are referring to is the difference between a straightforward sliding genioplasty and a ‘jumping’ genioplasty. I am not completely sure what you mean by a ‘mortisized genioplasty’ as that would refer to a bony genioglossus advancement only which would have no cosmetic benefit. That choice depends on which will give the greatest amount of chin advancement (which you need for your OSA) and what impact that would have on our appearance. With plate fixation the concept of a jumping sliding genioplasty has less significance than it did when only wire fixation was used. I would need to see pictures of your face and x-rays to best answer your question as to the optimal method of a sliding genioplasty for you.

Dr. Barry Eppley
Indianapolis, Indiana