Will Replacing My Chin Implant With A Sliding Genioplasty Help My Chin Tightness?

Q: Dr. Eppley, you did such a wonderful job informing me of all the options during my initial consultation and taking time to explain details.  Here are a few additional questions for you. 

1. How would we determine if I would need vertical lengthening as well as horizontal movement with chin implant in place?  Imaging? I have always felt my chin/ lower facial third was too “short” pre-implant.

2. If a very slight V shape is desired, would that require a  T- osteotomy in my case or would the genioplasty naturally provide that?

3.  Are there potential complications with teeth root damage?  How long does it typically take for the teeth tightness to disappear?  Any chance of permanent gum numbness?

4. My main motivation for the implant removal + genioplasty is to alleviate overall chin tightness and likely capsular contracture of implant-  if the incisional tightness persists post-genioplasty, would the fat graft and release of labiomental fold be a viable option?

Thank you, 

A:In answer to your questions:

1) Your are correct in that imaging is the way to determine if any vertical lengthening would be beneficial. I would compare the prior imaging sent to you, in which no significant vertical lengthening was done, with the new attached imaging in which vertical lengthening is added.

2) If you are getting vertical lengthening i would do a T-shaped genioplasty for the sake of a ‘slight’ V shape. That may occur naturally and also runs the risk of added scar tissue and tightness which is exactly what you are trying to treat.

3) There are no potential complications with tooth root damage as the osteotomy cut is well below the tooth roots. Most patients will experience some temporary lower incisor tooth numbness but that is not due to root damage.

4) Your secondary plan for persistent chin tightness is the appropriate one with the highest change of success.

Dr. Barry Eppley

Indianapolis, Indiana