Sliding genio vs. chin implant (require minimal risk, quicker downtime, less pain)?

Question

I'm attaching profile pics and ceph scan. What's better for me in terms of long term benefits, less risk, minimally invasive, providing the best SUBTLE results? Masculinization of the face is also preferred vs. narrower/feminine. Chin implant risks and pros/cons = include bone erosion, movement, displacement, infection and having the need for a revision? Sliding genio: numbness, infection, higher downtime (a couple weeks more??), not sure if it's any more or less painful. Purely cosmetic.

Alejandro Nogueira, MD · Answer

It is true the vast majority of surgeons use the implants instead of the osseous surgery to adjust the chin, but this is a matter just of lack of experience and comfort ease; implants play no role when there is an autologous alternative which, actually, has plenty of superior advantages.
Being an option, chin implants have serious disadvantages, especially in the mid and long term, patients are rarely happy with them after 5-6 years, all are out sooner or later. A quick research just on this website sheds light on the common, frequent and serious complications and side effects chin implants entail, like dislocation, malpositioning, infection, over or under corrections, visibility, fake looks, nerve damage, chronic pain, poor aesthetic results and in general patients' dissatisfaction; not to forget chin implants are not versatile, they are unable to provide vertical increase, horizontal axis modifications and in most cases sufficient anterior projection; as obvious as it sounds but we have to bear in mind chin implants play absolutely no role when the chin needs reduction of one of the spatial axes; actually it is very common receiving patients who seek chin implant removal and replacement by an osseous genioplasty in the same procedure.
Fillers, another tempting resource, are a very dangerous option in chin reshaping, potentially destructive, unable to reshape and enhance respecting the basic principles of anatomical beauty, leading to mid and long term serious complications (granulomas, deformities, fistulae, etc) and the worst is they can't be removed in most cases.
Burring the chin is, strictly said, osseous chin surgery but should neither be performed, ever, since just flattens the chin by destroying the natural dome of the jaw, deletes the labiomental crease and due to the detachment of the mentalis tendon this technique commonly leads to a droopy double chin, a serious aesthetic complication.
A multidimensional sliding genioplasty allows to a versatile surgeon full customization for augmenting, reducing and leveling the chin in any of its spatial axes, leading to a myriad of combinations to suit every individual's chin anatomy and facial balance requirements; you can masculinize, feminize, round or make square, increase, decrease, supply bone graft, remove bone portions, slide fragments, etc. This absolutely impossible with other method than multidimensional sliding geniplasty, a technique providing a series of advantages among which worth mentioning:-lifetime procedure, no more revision or renewal procedures, unlike implants-more natural than implants, the procedure is totally undetectable -no visibility of implant edges during gestures, expression is even improved, nicer smile-improves the double chin effect at the sub-mental muscles (floor of mouth) hammock caused by lack of tension there; also improves the shape and tension of perioral muscles and tightens up the jowls, creating a beneficial side effect in form of an indirect facelift and neck lift, all patients see their face indirectly rejuvenated; implants do not offer this feature-no future displacements or neuritis of mental nerves-no droopy double chin (the mentalis tendon is not detached) -way lower rate of postoperative complications if compared with implants, like infections, displacements, neuritis, etc-no need for complex plates and screws or teeth braces that may need future removal; just steel wires synthesis may suffice, they stay buried into bone callus producing no disturbance
The cons for the patient are essentially the costs associated with osseous genioplasties, however it sounds cheap if you consider the lifetime benefits; obviously the main disadvantage happens on surgeon's side, since it is more technically demanding than chin implants, few surgeons are experienced or comfortable with multidimensional osseous genioplasties (though I personally perform 100% of the chin procedures by this osseous method); patients have difficulty in finding surgeons experienced and comfortable in osseous genioplasties able to freely modify the chin shape and size based on their aesthetic and gender goals.
You'll find in this website hundreds of negative experiences with chin implants in the short and mid term, do read my profile's Q&A and you'll find them too. I am doing osseous genioplasties for more than 15 years with the highest success and no one patient sought afterwards switching to chin implants, totally the opposite, I did many chin implant removals and one-staged osseous genioplasties to replace the implant and enhance the result.
See the link below to find few cases of my own practice very similar to yours which I had the opportunity to operate successfully on, sharing a lot of common features with the technical problem you have posted.
If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also from underneath.
Feel free to request any additional information from me.

Larry S. Nichter, MD, MS, FACS · Answer

Without an exam your question cannot be answered.  You will need to see an Oral/Maxillofacial surgeon to see if othognathic surgery, genioplasty or using an implant is best for your specific case. It should be noted that patients with severely weak jaws or abnormally functioning jaws may be better treated with other facial surgery (orthognathic surgery), although a chin augmentation may be an option at a later time. These patients should seek the advice of a plastic surgeon to determine which course is right for them. Here is some information to help you make this decision: Candidates for Chin Augmentation - Patients whose chin profiles are weak but have normally functioning jaws are candidates for Chin Augmentation. Many of these candidates have used injectable fillers in the past to strengthen the protrusion of their chins, but are looking for a permanent solution. If you are one of these patients, then you are a likely candidate for chin augmentation
#weakchin #chinimplant

Michael P. Morrissette, DDS, FACS · Answer

I perform both these procedures in my office and you could achieve an excellent result with a chin implant. The chin implant is less invasive and when properly secured (with a screw or sutures) there is minimal risk of bone resorption. I would recommend placement through a skin incision which would allow for simultaneous jawline liposuction which would optimize your results. Good luck

Jonathan Kulbersh, MD · Answer

Sliding genioplasty is an extreme surgery that I don’t recommend unless you have functional issues. To fix the cosmetic problem of a weak chin, a chin implant would give you the correction you want. You must find an expert facial plastic surgeon to help you with this. I hope this helps.

Jeffrey Jumaily, MD · Answer

The short answer is chin implant meets your criteria better. It's subtle, less down time and less risk. If done well it shouldnt move and bone resorption is not a significant issues. Happy to help you if you wish.

Barry L. Eppley, MD, DMD · Answer

The questions you are asking about chin augmentation and the criteria you are imposing (least risk and subtle risk) would clearly point to an implant. The severity of your lower jaw/chin deficiency, however would point towards a sliding genioplasty as he better long term result even if it is more invasive with a longer recovery. But until computer imaging is done which will visually define what type of result you are seeking, it is not possible to determine which chin augmentation option is best for your needs.

William Portuese, MD · Answer

A sliding genioplasty is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay at the hospital, and is much more invasive. Placement of a chin implant is performed under local anesthesia as an outpatient procedure and takes approximately 30 minutes and is much less invasive.  Chin implants are manufactured in a large array of thicknesses, shapes, and sizes which is best determined time examination.For many examples of chin implants, please see the link and the video below

Michael Elam, MD (retired) · Answer

Dear anonymous, Personally I would suggest a chin augmentation with submental liposuction to provide a more defined jawline. Chin augmentation will add the necessary projection you need and is a simpler procedure, with minimal downtime. You can have sub-mental liposuction at the same time which will provide a stronger more masculine jawline. See examples in the video and link below. Best regards, Michael V. Elam, M.D.

David Alessi, MD - Account Suspended · Answer

Based on the photos taken, a chin implant would be a good choice.  The sliding genioplasty is a good option if there is a significant malocclusion (the bite isn't right).  The x-ray given doesn't seem to show this.  A chin implant can be done with an incision in the mouth.  If combined with liposuction, a small incision under the chin will be needed.  The complication and discomfort rates are much lower with a chin implant.  There is a chance of bone erosion, but is very low.  Of course, a full in-office assessment is needed to say which is best.  Seek out consult with a board-certified surgeon.  Best wishes.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  From the photos, your chin is very weak.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  
 Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut segments of bone).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.  Which is better, chin implant or sliding genioplasty.  We place silastic chin implants through a small, curved incision under the chin using local anesthetic in 30 minutes or less.  This is "far" less invasive than a sliding genioplasty that requires cuts in the bone with plates or screws.  For that reason and because the aesthetic results are so good with a properly placed silastic chin implant of the correct shape and size...in my humble opinion there's no comparison.  The chin implant is quicker, easier, with far less surgery and healing, less unwanted side effects with results that are highly effective and reliable. Hope this helps.

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