Sliding Genioplasty Revision

Q: Dr. Eppley, I am interested in a sliding genioplasty revision.I had a sliding genioplasty in Feb 2014 moving my chin forward around 8.5mm. From the start it looked like the result was asymmetrical. 2 years later this is definitely the case. From my attached photos you can see that the left side is sticking out of the face slightly when viewed from the front and there is also a step off when viewing from the side. I’d like to know what my options are.

A: Most asymmetries after a sliding genioplasty comes from differences in the angle and length of the bone cuts on the two sides. Even subtle differences become really apparent when the horizontal movement become bigger. This creates asymmetry from the appearance that the chin is rotated (which it may well be) but often it is just two different lengths of the bone cuts.

In correction of your chin asymmetry, the first piece of information that would be very helpful is to know exactly what the bone looks like. This is where a 3D CT scan can be enormously helpful in understanding your existing chin shape as well as planning what to do about. Fundamentally it comes down to either reduction of prominent bone wings or augmentation of bone wing deficiencies…or some combination there of. You appear to need this exact combination by both your picture and your description of the chin asymmetry.

Dr. Barry Eppley
Indianapolis, Indiana