What Is The Best Technique For Chin Narrowing?

Q: Dr. Eppley, I have a wide chin and am interested in a chin narrowing procedure. What is the best way to make the chin bone more narrow? 

A: The benefits of chin narrowing is very clear as you do have a boxy square chin. To obtain substantial chin narrowing there are two basic techniques, bony genioplasty wedge (sliding genioplasty with central wedge reduction) and lateral tubercle ostectomies. (cut off the corners without down fracturing the chin) There are advantages and disadvantages of each method of chin narrowing. Having done them both numerous times, they both can work but there are subtle differences between them that can carry aesthetic consequences. The advantage of the bony genioplasty wedge reduction method is that it does not strip off all the attached soft tissues so the risk of the soft tissues not adequately reattaching afterwards is minimized but it is a ‘bigger’ operation due to the need to down fracture the bone  and the bone cuts come closer to the exit of the mental nerve from the bone. (risk of numbness) The lateral tubercle ostectomy method merely cuts off the corner of the boxy chin and does not need to down fracture the chin bone and thus there is no need for plates and screws to put it back together.  Its bone cuts stay further from the mental nerve so the risk of lip numbness is less. Its disadvantage is that it may not produce as significant a chin narrowing effect and detaches more of the soft tissue.

Dr. Barry Eppley

Indianapolis, Indiana