What Is The Best Way To Make My Chin Smaller?

Q: Dr. Eppley, I had some type of chin reduction procedure 10 years ago (maybe burring down the bone?) but my neck and chin actually looks worse afterwards. I have attached some x-rays which show a single butterfly-type device with four screws, visible more so from the profile shots. Do you think the irregular bone shape underneath is contributing to any of this fullness? Or does this not matter? The wedge on the end looks like it is positioned a little high to me. Would something like F in the image below be a better option? I want my labiomental fold effaced more like the after-shot in F. Or could this also be achieved with bone burring? What are you thoughts about all this? I want to get rid of the bulbous shape and having small, short teeth doesn’t help matters out much.

A: Thank you for sending the x-rays. What they demonstrate is that you had a reverse sliding genioplasty for your chin reduction, not just a simple burring of the bone. (like image F in the genioplasty illustrations) That is why there is a 4-hole metal fixation plate and screws. This also explains, as I suspected, the submental fullness that developed and never changed after the procedure.

Repeating the original reverse genioplasty is only going to make your neck/submental area worse…and will not reduce the depth of the labiomental fold. Do not let that illustration fool you, it does not work that way in real life on the effects of the soft tissue above the chin bone. (anything can happen on a drawing)

I do think that the bottom of the chin bone needs to be reshaped (narrowed and reduced in height) but, again, that is not going to change the depth of the labiomental fold. Fat injection grafting is the best procedure to try and make that happen.

Dr. Barry Eppley