Sliding Genioplasty /chin implant or jaw surgery? (Photos)

Question

Would I be better off with a sg/ chin implant or full blown jaw surgery? I don’t have any bite problems but I feel like my jaw is kinda recessed. What would help me best to achieve a better jawline.

Randal Haworth, MD, FACS · Answer

There are a variety of techniques that can be used to augment 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. To address your concerns I would recommend having an in person consult with a board certified plastic surgeon who specializes in facial aesthetics.

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.

Ryan Chastant, MD · Answer

Thank you for your question. Since you stated that you don’t have functional issues with your jaw, I wouldn’t recommend a sliding genioplasty, as it is a pretty serious surgery that addresses functional problems as well as cosmetic. An implant is a fairly easy, minimally invasive way to augment the projection of your chin, but there are other options as well. Facial fillers have been used with success to add volume and shape to the chin. While they require a regular injection plan, the advantage is that you can experiment with more or less volume before committing to an implant. My best advice would be to consult with a facial plastic surgeon. They can examine you and offer options to achieve the best possible results. Good luck!
- Ryan Chastant, MD

William Portuese, MD · Answer

A sliding genioplasty is performed by an oral surgeon in a hospital setting with an overnight stay, and is much more invasive. Placement of the chin implant can be performed under local anesthesia, and takes approximately 30 minutes. Chin implants are in our practice are placed through a small incision underneath the chin. For many examples, please see the link and the video below

Barry L. Eppley, MD, DMD · Answer

Without a bite issue, orthognathic surgery is not indicated. With a vertically long and recessed chin some form of chin augmentation would be the best approach. Whether this should be a sliding genioplasty or chin implant can not be determined from just side view pictures and will require computer imaging from different angles to help make this decision.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and photos and I would go on some complimentary consultations with experts and compare recommendations and look at photos of similar patients and become informed about the desired procedure.Dr Corbin

Michael Elam, MD (retired) · Answer

Dear Robroro, if you do not have any issues with occlusion on your teeth then a chin augmentation with cervical and submental liposuction will provide a more balanced and stronger jawline. See examples in the link and video below. Best regards, Michael V. Elam, M.D.

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

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin. lips), liposuction and/or facelifts for over 30 years.  Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  Looking at your photos, your cheeks are very flat in the front, the chin is quite weak as are the mandibular angles and there is some excess fat and skin under the chin.  The following procedures would create a more ruggedly handsome face.
Cheek augmentation with silastic cheek implants to add angularity to the cheeks and mid face.  Liposuction can be combined to reduce any excess fat to further shape the cheeks and face.  Dermal filler (if precisely placed) can also be sued to augment the chin.  Fat should not be used and the reason why is discussed below.
Chin augmentation, using a silastic chin implant, to add projection to the chin creating harmony and balance to the lower face.  I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  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 bone segments).  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.  
Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.
 I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or silastic facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Sliding Genioplasty /chin implant or jaw surgery? (Photos)

Answers (8)

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