What Are My Options If I Want More Augmentation After A Sliding Genioplasty Done One Month Ago?
Q: Dr. Eppley, I had a sliding genioplasty four weeks ago (8mm forward and 2mms vertical) and initially it looked just perfect. But as the swelling has gone down I now know I really want more augmentation. I told the surgeon I would rather have too little than too much augmentation so I probably made the surgeon be too conservative. What are my options now?
A: The not uncommon patient preoperative phrase, ”I would rather have too little than too much’, is an abstract one that may change when looking at actual physical changes. This is not rare. An 8mm forward movement of the chin would not be considered conservative but it all depends on whom it is on, what their initial chin looked like and their interpretation of what looks good to them. But like all facial bone reshaping surgery one never knows how the patient will feel about a ‘new look’ until they actually have it done.
The approach to take depends on how much more horizontal augmentation is needed. (it is all about the millimeters)
Given his original amount of advancement and maintaining bone contact, there is probably only a few more millimeters to go by moving the bone further forward. (changing the plate to a 10 to 12mm plate) In other words maybe another 2 to 4mms with the chin for sure becoming a bit more narrow in the front viewing the notching in the side a bit more palpable..
The other approach is to add an implant on top of the advanced chin bone from a submental approach. This is a more versatile dimensional approach as the amount of horizontal augmentation is greater with added width to the chin as well.
Dr. Barry Eppley