Will A Secondary T-Shaped Genioplasty Help My Chin Ptosis?

Q: Dr. Eppley,I have a few additional questions about the secondary t-shaped genioplasty procedure.

I would be interested in a small amount (2-3mm) of additional narrowing at the same time as my projection is restored. Would this be possible given that I had a t-cut osteotomy as part of my original genioplasty in November, or would the risks of shattering/unwanted fracturing be too high? How much time passage between my original surgery and the revision would allow this cut to be done safely (or would it never be possible)?

Additionally, part of the reason I’m interested in restoring my projection is to address soft tissue laxity in the submental region and ptosis of the chin pad that has come from the horizontal reduction. If I were to have a few millimeters of narrowing, would that fully or partially negate the benefits of restoring the projection horizontally? What are the risks of ptosis from narrowing genioplasty vs from horizontal reduction?

A: In answer to your secondary bony genioplasty questions:

1) I would not advise doing a secondary narrowing of a t-shaped sliding genioplasty for a few extra millimeters of narrowing. That bony union is often incomplete and it never heals in a completely normal shape. Doing it a second time may risk further incomplete healing. Point being is that it is not worth it for that small amount of difference.

2) Any loss of bone support, regardless of the dimension, is another factor that either creates more or risks optimal improvement in the chin ptosis.

Dr. Barry Eppley

Indianapolis, Indiana