Would I benefit from a genioplasty or double jaw surgery? (Photos)

Question

I have always know my chin/ lower face is very unbalanced and I want to fix it, although I have no idea where to start. I wonder if a genioplasty and a rhino would be enough to balance my face but iam scared of having a witch chin.

Michael P. Morrissette, DDS, FACS · Answer

A double-jaw surgery will improve your bite. A sliding genioplasty will improve your facial balance. I advise patients that if they can eat a balanced diet, but are mainly concerned with aesthetics, then a sliding genioplasty is all that is necessary. The surgery takes less than an hour and is performed in the office with sedation. In your case, I would recommend bringing the chin forward and slightly increasing the length because of the deep mentolabial fold. No braces are needed for a sliding genioplasty.

Alejandro Nogueira, MD · Answer

Absolutely not, under no circumstances should you get orthognatic (double jaw) surgey, that's over aggressive and non indicated for your case.

You have reasons to fear a witch's chin, you already have a bit if it and once the chin has been moved forward this would be massively aggravated; to prevent this the chin, which is overly sharp now, has to be rounded and widened (to the point, a tad) so that the final outcome is a feminine and cute dome.

You have microgenia, this is small bone developtment at the chin, therefore you need chin augmentation with bone supply (iliac grafting); not a case for sliding genioplasty giving there's nothing to slide, it is primery deficit of bone substance.

Regarding the nose, it is not a bad one for you, you might consider getting the chin done in first instance and then see from there; if you dream of a perky tip and smaller nose then yes, you can get together rhino and genioplasty (aka profileplasty).

Seek the  services of a well experienced genioplasty surgeon, you are NOT a case for just a sliding genioplasty, much less for the poorly-outcomed chin implants.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear Ana,

Thank you for sharing your photo. From what I can see, the main area for improvement is in the lower third of your face. Your nose and upper jaw appear to be well-positioned, but your lower jaw and chin are somewhat recessed.
The optimal treatment would be a bilateral sagittal split osteotomy (lower jaw advancement), possibly combined with a sliding genioplasty, to bring your lower face into better harmony. This typically requires coordination with orthodontics for the best long-term bite and facial balance.
If you wish to avoid orthodontics and a full jaw procedure, then a sliding genioplasty alone could still improve your profile, though not as dramatically as the combined approach. A skilled surgeon can shape the chin advancement to avoid creating a “witch chin” appearance.
An in-person consultation with a board-certified oral & maxillofacial surgeon or plastic surgeon experienced in orthognathic surgery will allow precise measurements and a tailored plan.

Warmly,

Earl Stephenson, Jr, MD, DDS, MBA
ESJ Aesthetics — “Where Confidence Takes Shape!”

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