Q: Can a chin implant be done after a sliding genioplasty?
A: The premise of this question is that the result of the bony chin advancement did not produce the desired amount of horizontal chin projection. That could be because the bony chin was not moved forward enough or that the amount of chin advancement needed exceeded how much the bone could be safely moved forward.
Either way, an implant can easily be added onto the front of the chin bone. This is best done through a submental incision under the chin as would be done traditionally. Placing the implant on the front edge of the chin bone does not disrupt the healed chin bone and disrupt the blood supply to the bone. While it can also be placed through the same intraoral incision as the of the sliding genioplasty, this causes a lot of extra tissue disruption going through an area that is already scarred from previous surgery.
Gauging the amount of chin advancement needed is one of the most predictable forms of facial computer imaging. Since the chin soft tissue moves on a 1:1 basis with how the bone position changes, side view predictions can quite easily show how much movement is needed. In doing a sliding genioplasty, if one notes beforehand on the computer prediction imaging that it remains still horizontally deficient, an implant can be placed on the front of the chin at the same time as the chin bone is moved forward. I have done this successfully several times and it works to get 3 to 5 mms of chin projection if needed.
Dr. Barry Eppley