Will A Sliding Genioplasty Fix My Underbite?
Q: Dr. Eppley, I am interested in two facial procedures and I believe you are the right doctor to do them. I already have a chin implant in place but it is not ideal. I would like to have a sliding genioplasty to correct my underbite and have a slightly more balanced chin. Also I want buccal fat removal. I have a heavy lower face with full cheeks that I would like to look slightly more sculpted.
A: Based on the procedures you desire and your objectives, I would make the following comments and clarifications.
A sliding genioplasty is an alternative, and is sometimes better than a chin implant for more severe cases of chin deficiency. It will not, however, correct any occlusal problems as it is a chin procedure and not a total jaw advancement. The correction of one’s underbite requires a sagittal split ramus osteotomy jaw procedure (done in the back part of the lower jaw) which moves the tooth-bearing portion of the jaw bone. This requires pre- and post-surgical orthodontics. It fixes the bite as well as produces an amount of chin augmentation in millimeters that matches how far the lower teeth have moved to fit better to the upper teeth. Do not confuse a sliding genioplasty and a sagittal split mandibular osteotomy.
A buccal lipectomy removes fat and its associated fullness right under the cheek bone (submalar region) It does not create any slimming effect below this area. Most patients envision the entire cheek area done to and past the corner of the mouth when they refer to making their face less full. For this reason, many buccal lipectomies (done from a small incision inside the mouth) are combined with small cannula liposuction of the perioral mounds. (mound or fullness to the sides if the mouth or lower cheek region) This combination creates a better overall slimming effect.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.