What Type Of Geniopasty Do I Need That May Avoid The Need For Bimax Surgery?

Q: Dr. Eppley, I am currently consulting for bimax surgery (le fort I + BSSO with CCW rotation). I have mild OSA so there is some health justification, but if I am being honest my concern is primarily aesthetic and I do not think I would go through the cost and risk if there were an easier/better option. I have been told by some that jaw surgery is the only way to address my retrognathic mandible satisfactorily, and that genioplasty would produce subpar result (the chin would be jutting out, and would mess up my labiomental groove, etc) 

I am trying to figure out what other options there might be from a purely cosmetic angle and have heard good things about your clinic in terms of chin augmentation that is more sophisticated than common genioplasty you would get from the local plastic surgeon.

A: I believe what you are asking is whether a sliding bony genioplasty or even a custom chin implant would produce an aesthetic result comparable to that of a BSSO +/- genioplasty. Certainly that is a fair question given the magnitude and process of double jaw surgery. All I can really say just looking at a lateral cephalometric x-ray is that the horizontal projection of the chin needs to be at least 12mms, maybe a bit more. This indicates that a bony genioplasty would be the better procedure as opposed to an implant. But how that would look on you and its effects on the lower lip and labiomental fold requires computer imaging of your facial pictures to determine if you see that change as a desirable aesthetic improvement or that it looks unnatural.

Dr. Barry Eppley

Indianapolis, Indiana