What Is The Best Genioplasty Technique After A Prior Genioplasty For Further Chin Advancement?

Q: Dr. Eppley, I had a Lefort 1 and genioplasty in the past and it greatly improved my breathing and lip competence. However a small amount of lower lip incompetence persists. Fixing that lip incompetence is my main objective, though aesthetics are very important to me as well. Based on my pictures, what option do you reckon is ideal? 

1. Sliding genioplasty with horizontal advancement and no vertical changes 

2. Sliding genioplasty with horizontal advancement and 2-3mm vertical reduction via bending of the plate 

3. Jumping genioplasty 

A: Option #2 is the most viable one. A jumping genioplasty is rarely used because of the major bony stepoffs that it creates.

Dr. Barry Eppley

Indianapolis, Indiana