Do many doctors perform sliding genioplasty under twilight/IV sedation? (Photo)

Question

I’d like to avoid general anesthesia if possible, and am wondering if it is safe and common to perform a sliding/osseous genioplasty without general anesthesia. I’ve had wisdom teeth removal in the past and feel okay with IV sedation, but know that sliding genioplasty is more serious and twilight sedation may not be suitable for it. I’ve also considered a chin implant, but think sliding genioplasty may provide a better and more stable result. Any insight into what’s possible would really help!

Timothy Osborn, MD · Answer

There are only a handful of licensed facial surgeons who can/should perform a genioplasty. I am unsure exactly how many will perform the surgery without general anesthesia. With that being said, our office does use IV sedation for a moderate sedation, but not under general. Patients are breathing on their own and maintaining all of their functions without assistance. It is extremely safe. We do about 1 a week here in our surgical center. One of the many benefits of performing surgery this way, is that without needing intubation, we are able to see the chin placement in real time (there is no tube in the way). This shows us what your chin will actually look like for the final result. We are happy to schedule an in-person or virtual consult if you would like to discuss things further and answer any questions you may have!

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Excellent questions. For a sliding genioplasty, there tends to be a good amount of bleeding during the surgery. This is normal given that bone is being manipulated which has a solid blood supply. Twilight anesthesia works well in situations where there isn't going to be any blood near the airway. If blood enters, your reflexes aren't as "alert" and you could aspirate which causes serious problems. I would suggest general anesthesia given the location of the procedure (within the mouth). It is very safe for healthy patients and the recovery is often mild. Hope this is useful!

Gerald Wittenberg, MSc, DMD (retired) · Answer

It certainly is a good idea and common to some of us. However, not all surgeons will have the facilities nor the experience/interest to do so; best to ask your surgeon. It does allow for a rapid recovery. Both are considered safe however.

Do many doctors perform sliding genioplasty under twilight/IV sedation? (Photo)

Answers (3)

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