Chin Implant Vs Sliding Genioplasty

Great question.  This comes up quite often in consultation.  The preferred method is chin implant in the vast majority of cases.  With sliding genioplasty you can get projection and add some height, but it requires fracturing the bone and adding hardware such as plates and screws to secure in place which creates swelling for weeks.  The problem with a sliding genioplasty, besides the risks and downtime, is that it doesn't really provide much lateral augmentation on either side of the chin.A chin implant can add vertical height (we have implants that can do this as of 2017), lateral augmentation, projection, or it can be customize to add more laterally than centrally.  The biggest advantage to chin implants is the fact that they can be easily reversed by taking the implant out in the office under 5 min if the patient doesn't like it.  The risks, in my opinion, are less, downtime is less, and the procedure is reversible.  

The simplest explanation is that sliding genioplasty is used most often for assymetries of bone while an implant is best used when their is symmetry of sides.  Many genioplasties are performed in the setting of a normal chin enhancement.

The choice between a  chin implant or a sliding genioplasty depends on the individual patient's's anatomy.  Most patients would be better served with a well planned and executed Chin implant augmentation.  Sliding genioplasty has a higher complication profile, and should be reserved for the patients that can not be helped with chin implant surgery alone.  A well trained and experienced surgeon should be able to guild you in your choice.

These can achieve different results and there is no one correct operation for all patients. You should discuss these options with your surgeon and review the risks alternatives and beneifts.
Implants can be removed and are therefore have the potential to reverse the surgical results if desired. Sliding or osseous genioplasty is a technically more challenging surgical procedure and does involve greater risk.

Both a chin implant and a sliding genioplasty can be very effective for augmentation. However, only a sliding genioplasty can recess a chin, lengthen the chin, as well as correct an assymetry.

Hello,This is a topoic that you will get different answers from different specialists.  First you have to make sure that the problem is chin and not the jaw. Once that is rule out, then you can start deciding on the two options. I believe you can get the same projection with both procedures.  I do not think placing a large implant is a good idea.  If  more than 5-6 mm of chin advancement  needed, jaw surgery would probably be the ideal surgery to begin with. The vertical positioning depends on your facial height. This should be measured on X-rays and clinically. If height needed, then S.G. is the only way to go.

Chin implant versus sliding genioplasty is a big decision. A chin implant is inserted for cosmetic purposes up to about 8 or 9 mm of anterior projection. Chin implants to give a few millimeters of added height and width, since the implant is three-dimensional. Chin implants are placed through a sub mental  incision under local anesthesia as an outpatient procedure. A sliding genioplasty is performed under general anesthesia and usually requires an in-hospital stay for 24-48 hours after the procedure. It's best to perform this procedure when the teeth are significantly out of alignment and  there is a significant bony deficiency present, and more than 10 mm of augmentation is required.  

While chin implants are by far the most common method of chin augmentation, they are not ideal for absolutely everyone. Large chin deficiencies as well as vertical chin problems may be better treated by moving the chin bone to a better position. When horizontal chin deficiences are greater than 10mms (as determined by a side view picture), then one needs to carefully consider the osteotomy option. Off-the-shelf chin implants do not usually give more than 10mm of projection. When the chin is vertically short and needs to be lengthened or when it is too long and needs to be shortened, an osteotomy is the only treatment option.

As a craniofacial surgeon (one who is board certified in plastic surgery and fellowship-trained in craniofacial surgery), I have performed numerous sliding genioplasties as well as implant procedures to strengthen the chin. Both procedures are very straight forward, take about the same amount of time to perform, and can be effective in most cases.  However, there are multiple benefits to performing a genioplasty in which the chin is cut and the bone is advanced and then secured in position with a small titanium plate.  There is no risk of implant infection when performing a genioplasty in which your own bone is used to achieve the augmentation. Chin implants are also prone to shifting position resulting in post-op asymmetry; this doesn't occur with a sliding genioplasty as the bone is secured in place.  Both procedures can be performed through a similar intra-oral incision.  Placing the implant through this approach increases the chance of infection. Placing it through an external incision on the chin to reduce the chance of infection produces a visible scar. As every patient is different, be sure to review the details of each procedure carefully with your surgeon to make the best choice for yourself.

Chin augmentation can be done by either adding an artificial material (chin implant) or by moving your own bone forward (sliding genioplasty).  A sliding genioplasty is a much more complex operation, requires a larger incision, has a higher rate of complication, is far more dificult to undo, has a longer healing time, and puts your teeth and nerves at greater risk.  In addition, there are dozens of chin implant shapes and sizes to pick from compared to very limited options with a sliding genioplasty. 
I use silastic chin implants which I insert via a 1/2 inch incision either inside your mouth or under your chin (you choose).  Silastic is a material which has been used for this purpose for decades and is known to be safe.  Their is usually no bruising, minimal pain, mild swelling, and very rare complication.  The operation can easily be done under local anesthesia, if you like, allowing you to drive home.  It takes about 30 minutes total and if you choose to be awake you can even inspect your appearance with several sizes before finalizing things.
We do know that chin implants tend to put a dent in the bone after a while.  This is not a problem unless you decide to remove or change out the implant at a later time.  If you change your mind about an implant (either just don't like it at all or want a different size), it very easy to switch for the first several months.  Later than that and the operation gets more difficult becuase of the ridge in the bone, but it still can be done.