Q: Dr. Eppley, I had a sliding genioplasty and jaw recontouring (after I had upper and lower jaw surgery previously with a different doctor). After the sliding genioplasty and jaw recontouring my chin still wasn’t in the middle and I am unhappy with the shape of my jawline,. It seems to have a lot of dents after the surgery (see the before and after x-rays). Is it normal after jaw recontouring and sliding genioplasty to have this kind of irregularities and is it possible to get more symmetry? I hope you can help me with these questions.
A: Thank you for your inquiry and sending your x-rays. What I can see on the x-rays is that the left jawline looks very irregular from the chin on back to the jaw angle and has clearly been surgically manipulated. Curiously the right side of the jawline looks fairly pristine…almost as if it has never had surgery at all. I can not appreciate the chin asymmetry as the x-rays shows a bony chin that looks midline. The left lower border looks a little irregular. How this correlates to what you look like on the outside would be relevant to whether and want you should do next. In looking at your pictures of your past jaw recontouring efforts, you look just like your x-rays with a very irregular left jawline and chin asymmetry. I would recommend you get a 3D CT scan from which a custom inferior border implant that would extend from the chin back to the jaw angle to improve your jawline and chin asymmetry.
Dr. Barry Eppley