Sliding Genioplasty Revision

Q: Dr. Eppley, I had a sliding genioplasty 1.5 years ago and though it was predicted I still see quite large “edges” on one side, but actually both side of the face around the edges needs some kind of filling. My other issue is the deep mentolabial fold which is not the result of the surgery as I always had it, but I’m wondering if this can be addressed with some kind of further surgery or fillers etc. Also notice the “curved” end of the chin, I’m wondering what causes that?

A:You have all of the classic minor aesthetic issues that come from a sliding genioplasty of more than a few millimeters of anterior movement. Stepoffs at the back end of the osteotomy, deepening of the labiodental fold and a rounded anterior projection of the chin.  These are all due to the U-shape of the anterior jaw being pulled forward into a more narrow u-shape. There are a variety of augmentation strategies for the back of the osteotomies an the labiodental fold. The curved end of the chin can only be proved by placing an implant in front of the bone. These are all strategies to use in a sliding genioplasty revision.

Dr. Barry Eppley
Indianapolis, Indiana