Would A Sliding Genioplasty Or A Wrap Around Jaw Implant Make My Face More Balanced?

Q: I want a stronger chin and jawline. I currently have a 7 mm winged chin implant in now (with rhinoplasty last year), but feel the asymmetry lies more in the vertical dimension. I also feel that my mandible does not have enough lateral dimension or width. It seems that my lower face is somewhat deficient in multiple planes and I’m unsure which would be better for me, a chin osteotomy with vertical and horizontal augmentation combined with a widening of chin, or a custom wrap around implant. It might be helpful to see the predicted outcomes of both. And, of course, I would love to hear what you think might be best based on the picturesI have attached. Any other suggestions you might have would be appreciated also.

A: I think factoring in all considerations and looking at some imaging predictions, I would opt for the chin osteotomy. The recovery time is actually shorter with the implant but the photographic projections shows what an osteotomy can do and that seems to be the bulk of where the change needs to be to get your face more balanced. Given your 7mm implant that is already in place, your osteotomy needs to come forward 11mms and down at least 7mms. This will require plate fixation and hydroxyapatite block grafts.

Also I have noted that you could benefit from nostril widening. That parft seems to have been overlooked in your original rhinoplasty as well as some additional tip refinement. I would also consider adding in buccal fat removal for submalar narrowing and this would add nothing to the recovery time.

Dr. Barry Eppley

Indianapolis Indiana