Sliding Genioplasty For Combined Horizontal and Vertical Projection
Q: Dr. Eppley, I am happy to hear I am a candidate for a sliding genioplasty. I scheduled a consultation for next month to discuss more. Before then, I had two follow-up questions. I understand completely if this is too much for email and would need to be discussed during a consultation. I apologize if this is the case. I just thought I’d ask since the consult is a ways into the future.
1) I was hoping to not have such a scrunched up chin when looking down. I was also hoping to improve support to my lower lip so that it hangs less when my mouth is open (photos attached). Would a genioplasty help with these things?
2) I am nervous about two possibilities from a genioplasty – an overly pointy chin/deep mentolabial fold and a thinned/pulled down lower lip (photos attached). One of the key reasons I was hopeful for a genioplasty and not an implant was that I read on your website that soft-tissue changes were more predictable with a genioplasty. Could the above two results be mostly avoided?
Again, I really appreciate your time and your website as a resource.
A: 1) While in theory a sliding genioplasty could help improve lower lip support in some patients, I don’t think in your case that would probably happen. That tends to occur with large horizontal bony movement in patients with really weak chins who have significant preoperative lower lip incompetence.
2) With the relatively small horizontal bony movement you would be getting, a deeper labiomental fold is not going to occur. This is also aided by the vertical lengthening which often helps prevent a deeper labiomental fold from occurring., You can also hedge against that from occurring by grafting the bony step off of the sliding genioplasty with some demineralized bone granules.
3) I have never seen the lower lip pulled down with either a chin implant or a sliding genioplasty.
Dr. Barry Eppley