Is a sliding genioplasty with submental lipo the best option for the results I want? (Photos)

Question

I don't like my profile. I can't put my finger on what the issue is or what could be done to fix it.. but I want a more defined jawline and a prettier chin area. One surgeon said submental lipo and a sliding genioplasty be the best option?

Randal Haworth, MD, FACS · Answer

There are a variety of techniques that can be used to augmented the chin and improve your profile. A more temporary approach includes dermal fillers (e.g., Sculptra, Voluma, and Radiesse), while fat grafting, use of permanent fillers (Aquamid, Bellafill ) and facial implants would offer a more permanent solution. A sliding genioplasty is a procedure that I feel gives a rather blocky, unrefined look in a number of cases. However, in severe cases, this may be the best option. One also has to evaluate your actual bite through orthgnathic analysis and possible orthodontia.  Additionally, liposuction of your submental region all the way back to your ears can be performed to highlight your jaw line and give you a more elegant shadow. To address your concerns I would recommend having an in person consult with a board certified plastic surgeon who specializes in facial aesthetics and contouring.

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

Jeffrey Watson, MD · Answer

Great question! I've posted a video below so that you can see how to determine whether you are a chin implant candidate. I believe that you are by your photo but the video shows you how I judge this with my patients. The key question is whether you proceed with a chin implant which is a cosmetic surgery that is quite straightforward for an experienced surgeon. The alternative, a sliding genioplasty, addresses your bite while changing your chin position. If you wish to have your teeth realigned you are best served by seeing an oral surgeon in consultation. If your concerns are cosmetic and enhancing your chin to bring it in to balance with your other features--then a chin implant is the way to go. 
For you, yes a bit of submental lipo will give you a bit more definition. The celebrity photo is rarely achievable due to the position of muscles under the chin in most people (not fat) which limits how much you can get that neck line. That said, you may get an extra 20% benefit by adding submental lipo and I would recommend it. 
You will generally find that rhinoplasty surgeons tend to have extensive experience with chin implantation because it is such a frequently performed procedure in conjunction with rhinoplasty. The incision can be made through the skin or through the mouth but i prefer to do it inside the mouth because it has minimal discomfort and is invisible without any external evidence of scar. My patients tend to be very happy with this approach. I hope that information is helpful!
I hope that helps!
Jeffrey Watson, MD
Fellowship Trained Facial Plastic Surgeon and Rhinoplasty Specialist
Board Certified Ear, Nose, and Throat Surgery
Graduate, Harvard Medical School

William Portuese, MD · Answer

A sliding genioplasty is performed by an oral surgeon under general anesthesia in a hospital  setting with an overnight hospital stay. A sliding genioplasty is usually performed with the teeth are significantly out of alignment. Consider chin implant for a cosmetic augmentation of the  chin  forward which will help with facial balance and proportions. Chin implants are manufactured in a large array of sizes and shapes which is best determined at the time of the consultation and examination, since both the chin and the implants are three-dimensional structures. Liposuction in the neck can accomplish improvement of the jawline. Both procedures can be performed  under local anesthesia as an outpatient surgical procedure.  Please see the link below for many examples of chin implant and neck liposuction procedures

Talmage J. Raine, MD, FACS (retired) · Answer

The picture you use for your goal is an extreme angle of your neck. That woman is iconically beautiful. Your profile is not bad, and had you not shown me your goal, I would have recommended a small chin implant to balance the overall look. I am just being honest. To achieve the more extreme angle you desire would also require a submental corsette platysmaplasty. That should get you close.All the best,Talmage Raine MD

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 of your profile compared to the desired "example", your chin is quite weak as are the back portions of your jaw line.  There is a "slight" amount of fat in the neck and below the chin however, removing this by itself would have very little if any effect.  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.   The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).Hope this helps.

Jay M. Pensler, MD - Account Suspended · Answer

I think you have a retruded chin.The two options for improvement would be either a chin implant or a genioplasty. each procedure has its advantages and disadvantages.

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