Is this level of advancement realistic with sliding genioplasty? (Photo)

It should be possible, but it would be a large advancement; around 12mm. With a movement that big, we may end up using some bone grafts to help fill in the gap (we typically do not use any for under 10mm). It sounds like you have done some research which is good. You may also be a candidate for jaw surgery, but many factors go into deciding whether or not that is the right decision for you. That being said, if you are only looking for cosmetic procedures, a genioplasty would be your best option. If after the genioplasty fully healed (3-6months) and you are still looking for more projection, you can have a second one. When the bone has completely filled in the gap and the skin and tissue has settled, an additional genioplasty can be performed. The only difference is the hardware would be removed and replaced with new ones once the second advancement was made. An implant can be used, but that is more common in people who are looking to fill in space around their jowls. Implants are typically bulky and have limited placement options (and would not be put in at the same time of the genioplasty). In the end, I think you would be satisfied with just the one genioplasty. The entire procedure is done through the mouth, which means no external incisions or scarring. Our office provides in-person or virtual consultations if you would like to discuss options further!

I perform both sliding genioplasties and chin implants. The maximum amount of advancement with the genioplasty is 9-10 mm. I usually perform this procedure first. If the patient is satisfied, then no further treatment is needed. If a patient requires further advancement, then a chin implant is placed 4-6 months later allowing for all the swelling to resolve. Both procedures are performed in the office with sedation anesthesia and patients typically return to work in 3-5 days. There is no change to the bite or teeth.

A sliding genioplasty is performed by an oral surgeon Under general anesthesia in a hospital setting with an overnight stay, and is much more invasive. It's usually done when the teeth are significantly out of alignment. If you're looking for purely cosmetic improvement, then consider placement of a medium sized chin implant, which can be performed under local anesthesia which takes about 30 minutes.