Will A Sliding Genioplasty Reversal Make Me Look Like My I Before?
Q: Dr. Eppley, I am about three months post op sliding genioplasty to advance my chin forward 6mm. The surgery made my lower part of face more narrow with a clear step off in my jaw line which was not there before and I still have mentalis strain. Actually I like my face before and I didn’t want it to change in the frontal view, just wanted a little projection to improve my profile. My surgeon told me nothing will change in front but now I see dramatic changes. I’m thinking of reversing the surgery and I have questions regarding that option. In case of full reversal am I going to regain my old look and the step off will go away? Risk of skin sagging? And when I can use injectable after surgery? Thank you.
A: When the chin is moved forward by sliding genioplasty there are almost always two aesthetic ‘side effects’ of the procedure. It is not a question of whether they will be there but how much and how noticeable will they be to the patient. First, as the chin comes by bone movement the front end of the jawline will appear more narrow. This is a simple principle of a U-shape that is being extended, the U will become more like a V. Secondly, the back ends of the sliding genioplasty will leave some degree of step-off along the inferior border of the jaw. The bigger the bony chin advancement the bigger these step-offs may be.
In a sliding genioplasty reversal, it is important to recognize that you probably will never be 100% exactly like it was before. The bone may be perfectly repositioned back but how the soft tissues, which have been traumatized and stretched, will respond is unknown but to be 100% like you were before can not be guaranteed. If you are young there should be no residual chin soft tissue sagging and the bony step-off should be gone. Most of the time the issue will be how the lower lip responds with a two-time mentalis muscle disruption/repair.
Dr. Barry Eppley