Sliding Genioplasty Revision

Q: Dr. Eppley, When an individual gets revision for sliding genioplasty, three to four months after initial procedure, and the same cut that was used in the initial procedure is traced and used again for the revision? is bone freshening a requirement? 

Meaning do the end segments of the bone have to be “freshened” or can the cut simply be traced and reused without such practice taking place?

I think I remember hearing that freshening the bone segments or doing ‘something’ with them (can’t recall the exact maneuver) is necessary if nonunion is to be prevented. Is this true?

A: In a sliding genioplasty revision  you have to make a fresh bone cut. In essence the exact original procedure is redone if the procedure is done after the bone is healing. (6 to 8 weeks after the first surgery)  I assume this is what you mean by ‘bone freshening’. Before the bone is healed, the down fractured bone segment can be simply unscrewed,  repositioned and then resecured.

Usually one doesn’t have a good idea as to the final result (3 months afterward) until the bone is healed. So most sliding genioplasty revision procedures require a new bone cut to do.

Dr. Barry Eppley
Indianapolis, Indiana