Can a sliding genioplasty or similar procedure be done without adding vertical projection?

Question

Hello! I'm considering a sliding genioplasty to add horizontal projection to my chin, but my chin is already pretty long as it is. (Think Reese Witherspoon except without the nice side profile!) Can a sliding genioplasty or similar procedure be done without adding vertical projection? I'm fairly young so I would rather not have a chin implant.

Michael P. Morrissette, DDS, FACS · Answer

Most patients who have the appearance of a long chin are usually over-projected and require reduction genioplasty. Patients who have a recessed chin tend to appear short and the advancement gives the appearance of a longer lower face when viewed from the front. Photographs and/or x-rays would be beneficial to help with making recommendations.

Farhad Rafizadeh, MD · Answer

The sliding genioplasty is done by making an oblique cut in the chin and allowing the lower chin segment to move forward and then maintaining it's location with a small plate and screws. This normally reduces the vertical height as it increases the forward projection. depending on the angle of the cut the vertical height could be maintained. Your surgeon can answer this best as he has seen you X rays. Chin implants could add forward projection without adding vertical height and I think this is a much simpler operation.

Bryan Rolfes, MD · Answer

Yes, the cuts in the bone can angled a way that a sliding genioplasty can either add height, reduce height, or maintain it.  If your age is the only reason your are writing off a chin implant I would encourage you to keep an open mind.  A well placed implant will easily last a lifetime, and at the same time they are easier to reverse or change than a genioplasty.  The most common reason I recommend a genioplasty is to make unique changes that there isn't a perfect implant for.  -Dr. Rolfes

Jeffrey H. Spiegel, MD · Answer

Of course, a photograph is quite helpful to allow us to determine the best course of action.  The chin and jaw can be adjusted in many ways very safely and effectively.

Barry L. Eppley, MD, DMD · Answer

A sliding genioplasty can vertically shorten the chin as it comes forward if concerns exist about it becoming too long. That is done based in either bone cut and/or how the chin plate is applied.

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.  Non smiling, resting photos of your face from the front and side would help in the evaluation.Looking at the vast majority of faces, they tend to have equal vertical segments  upper, mid and lower face.  In my experience this is typically the case.  When the chin is weak, this causes the lower vertical segment of the face to appear weak creating the "illusion" of a shortened vertical dimension.  Take a look at the attached video "before" and "after" placement of silastic chin implants illustrating that point.  Chin augmentation is best achieved when selecting the proper shape/size silastic implant and properly placing it such that it restores the proper horizontal projection to the chin.  An "expert" chin implant surgeon will understand and follow this "basic" concept.
 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. 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.    
Hope this helps.

Richard Galitz, MD, FACS (in memoriam) · Answer

It is very difficult to advise you on the basis of your question without a photograph. You say your chin is pretty long but you want to add horizontal projection which does not make a lot of sense....I'm not sure why you say your side profile is not nice if it is appropriately long. A sliding genioplasty by the nature of the operation will often add some vertical dimension ( depending on the angle of the cuts ) to your profile and is sometimes hard to avoid with this procedure...this is one reason I prefer chin implant to get chin projection.
I don't think your age is an issue regarding chin implants. I have been placing chin implants for thirty years and have yet to see a single one ever create a need for removal or any other complication. Once you have undergone successful chin implant surgery its in place for life without issue, unless you suffer sever trauma to your chin area.
What you need to consider is this. A chin implant is performed under local anesthesia in my office operating room in under 30 minutes with very little possibility of complications. In two or three days you look fantastic and feel almost like nothing happened. It also should last your lifetime. A sliding genioplasty involves bigger anesthesia, involves bone chiseling and sawing, and has a much greater incidence of associated complications regarding both nerve injury and asymmetry concerns. I long ago stopped doing sliding genioplasties and have never regretted it. You can see the excellent results of my patients on display on the right.

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