Q: Dr. Eppley, I am very interested in having a chin implant removed while having a genioplasty in its place. However I noticed your article in which you state that the genioplasty can be altered through a midline incision to narrow the bone. Can this midline incision also be used to widen the chin? Therefore augmenting my chin forward with the genioplasty while making it wider with the midline incision?
A: A sliding genioplasty can be done where the bone is expanded through a midline sagittal bone cut and the placement of an interpostional bone graft. (allogeneic bone is usually used) This requires more than one metal plate for fixation because of the two independent bone segments (unlike a typical sliding genioplasty which just uses one central plate) but such a widening bony geniplasty can be done. Whether it can achieve the exact effect you are trying to accomplish in the amount of chin width expansion would require computer imaging assessment before surgery. The amount of chin bone expansion by this technique is limited to 1m or less. This would not be enough to replicate what the width of a square chin implant could achieve in most cases.
Dr. Barry Eppley