Why Is A Sliding Genioplasty Preferred Over A Chin Implant In My Case?

Q: Dr. Eppley, I attached photos some of myself from different angles, a morph of myself in the profile view with a possible rhinoplasty and a few “desired aesthetic” photos.  Thank you!

Background:

•I believe I have a weak chin from the profile view and I am unsure if my chin is too short from the front view

•I did breathe through my mouth as a child. As an adult I do not typically breathe through my mouth, only occasionally when I sleep I believe I do

•I had braces when I was around 11years old and it was done by my dentist.

•The middle split in my front tooth seems to be off center with respect to the center of my lip

•One side of teeth seem to be higher than the other side

•I plan on doing rhinoplasty prior to a genioplasty or jaw surgery

•I am looking to get a more defined jawline and a stronger chin that is still feminine

Questions:

1.Out of curiosity, why was genioplasty recommended over a chin implant?

2. Based on my history and photos, is jaw surgery recommended, or would a genioplasty and shaving down one front tooth suffice?

3.Is the morph I created possible/recommended?

4.Would genioplasty be able to give me a more defined jawline?

5.Is it recommended to get rhinoplasty or genioplasty first?

6.How much improvement should I expect for my lip incompetence and mentalis muscle strain with the genioplasty? Is there a way to completely or mostly remove these issues?

A: Thank.you for sending your pictures. In answer to your questions:

1) Give the shortness of your chin and to prevent it from becoming too wide, if you were only doing chin augmentation a sliding genioplasty would be the preferred method. Your chin deficiency is at least or close to 10mms which is beyond what most chin implants can do. It is also important in a female to keep your chin narrow. A sliding genioplasty will improve symptoms such as lip incompetence and mentalis strain far better than an implant.

2) You can not make the determination about whether orthognathic surgery (lower jaw advancement) would be indicated based on facial pictures alone. This requires x-rays and an occlusal assessment.

3) To do computer imaging I need all three facial views particularly the side view of you…which is not in the pictures sent.

4) Genioplasty improves the chin…not the jawline behind it. No form of chin surgery makes a better ‘jawline’. Most people when they refer to jawline mean the back part of the jaw or jaw angles. That requires a different procedure than any form of chin augmentation.

5) The order between rhinoplasty and genioplasty is a personal one. There is no right or wrong order. It is all about what you value first.

6) While a sliding genioplasty will help with lower lip incompetence and mentalis strain there is no predicting beforehand how much it will improve.

Dr. Barry Eppley

Indianapolis, Indiana