Sliding Genioplasty Vs Chin Implant

Question

I saw a plastic surgeon last year and we discussed buccal fat removal and sliding genioplasty. I've held off on the surgery due to the risks.

	Would a chin implant work in my case? I'm hoping for options with less risk of complications than the sliding genioplasty. What do you suggest in my situation? I'm 24 years old and very unhappy with the lower half of my face. Thank you!

Richard H. Tholen, MD, FACS · Answer

I'm assuming your bite and occlusion are normal; otherwise, an oral surgeon or orthodontist should complete their work first, and then you should get several opinions from board-certified plastic surgeons or facial plastic surgeons.

The chin implant surgery is easier to perform, less likely to have complications, and quicker to recover from. BTW, I recommend the submental incision (under the chin), since the intraoral incision has a higher risk of infection for which the implant has to be removed to cure the infection. The properly-performed and accurately-closed incision heals with an imperceptible scar in virtually all individuals. I would recommend a Flowers mandibular glove vertical tilt extended anatomic chin implant (size small or medium). Since this implant is a hard silicone elastomer (not soft and squishy like breast implants) and is placed in an exact-size pocket beneath the bone periosteum, it cannot shift when healed, and feels just like your own chin.

Sliding genioplasty has visible and palpable step-off where the bone is cut (despite the judicious use of bone dust and/or hydroxyapatite granules), and must heal like the (intentional) fracture it is. It's probably more expensive, and the claims of implants being "not natural" and "Your own bone is all-natural" is disingenuous--the cut bones must be held together by titanium plates and screws which are (guess what?) "not natural!"

Buccal fat pad removal is not recommended as it can yield a "hollow-cheek" Skeletor look--know what I mean? You will likely regret this later in life. Rather, conservative cheek implants (again, NOT placed via an intraoral route, but rather via lower eyelid incisions) may give you a more balanced and harmonious facial balance. In addition to the link below, see also my patient with cheek implants. Best wishes! Dr. Tholen

Dhaval M. Patel, MD · Answer

Thank you for your question and photo!  I would suggest you seek a board certified plastic surgeon and have a consultation!  A chin implant would be the best fit for you.  Best of luck!Dr Dhaval PatelDouble Board Certified Plastic SurgeonChicagoHoffman EstatesOak Brook

Thomas A. Lamperti, MD · Answer

Either method of augmentating the chin has their role and some patients (and surgeons) prefer one approach to the other.

	It would be helpfult to talk to a surgeon that offers both techniques. A chin implant can certainly improve the projection in the area that concerns you.

Edward J. Gross, MD · Answer

Your profile photo demonstrates a mild to moderate microgenia (or weak chin). I would recommend a Chin Implant to improve this area. The external approach has the quickest recovery and the lowest risk of complication. Dr. G

Frank P. Fechner, MD · Answer

Personally, I prefer chin implant to sliding genioplasty. This preference is mainly guided by the final esthetic outcome which, in my opinion, is superior with chin implant. Why? With the boney advancement, only the central chin bone itself is advanced leaving the patient with a relative deficit in the sides of the chin - an area commonly referred to as prejowls. The chin implant provides a softer enhancement because it extends more to the sides and allows for a gentler transition. As a side effect, the recovery after chin implant is usually easier and quicker than after bone alteration.

	A quick word regarding your cheek: I would hesitate to recommend buccal fat removal. Your face is already relatively long and narrow and reduction of your lower cheeks will further accentuate this. Rather, consider cheek upper cheek enhancement which will widen your narrow upper face and improve the overall balance of the face. Buccal fat extraction is a procedure that is commonly is seen with regret years later.

	Isn't it interesting how cosmetic facial surgeons have differing views on how to enhance the face?

Jose Barrera, MD · Answer

I understand your concerns for improving your profile. The decision to undergo rhinoplasty and chin surgery is a personal one. Your goals need to be defined with the help of an esthetic facial surgeon. A well defined chin balances the face and creates a more aesthetic profile. A balanced chin also helps define the neck line improving sagging jowls and the neck line. Chin implant or genioplasty surgery may be necessary for functional reasons such as sleep apnea, retrognathia, or microgenia (small chin) or a large chin. I've attached a photo of one of my patients after rhinoplasty to improve the her profile and a genioplasty to reduce the size of the chin and offer a balanced profile. Ultimately, I recommend seeing a facial plastic surgeon for a consultation.

David C. Mabrie, MD · Answer

Between sliding genioplasty and chin implant surgery I prefer chin implant surgery because it does not involve cutting the bone, it may easily be modified, and has less risks.

	Reviewing your photos, I don't think you need buccal fat reduction, your face would look great with fillers placed to the cheek bone area and secondarily with some augmentation of your chin.  The amount of chin augmentation you need is small though and could be achieved with fillers and a non-surgical chin augmentation.

	Augmenting the cheek bones and midface with fillers would enhance the upper part of your face and de-emphasize the lower third.

	Good luck with your search for information.

William Portuese, MD · Answer

A chin implant is placed over the bone to bring the chin forward and into balance with your facial features. A small incision approximately ½ inch long is made underneath the chin; the implant is then inserted through and positioned directly over the bone. Chin augmentation with an implant is totally reversible, so if the patient ever desires to have it removed, it can easily be done. Placement or removal of a chin implant can be done under local anesthesia in an outpatient surgery center setting.

Houtan Chaboki, MD · Answer

Small or receded chins are relatively common. While more appropriate for a woman, small chins are usually not ideal for a man. Chin augmentation is normally combined with rhinoplasty or face lift surgery, or done alone. Chin treatment options include the following:

	
		    orthognathic surgery - teeth are aligned, upper & lower jaws are broken, and both are brought forward
	
		    sliding genioplasty - lower jaw chin bone advanced, without teeth alignment
	
		    chin implant - material placed in front of chin bone, typically silicone


	Each has its advantages and disadvantages, and each is not appropriate for everyone. Silicone chin implant is the most common procedure to augment the chin and improve the jawline. Based on your photographs, you may be a candidate for chin augmenation. The chin surgery could potentially be combined with buccal fat reduction for facial sculpting. Only after a comprehensive evaluation can a plastic surgeon help determine appropriate options for you. Best of luck.

	Dr. Chaboki

Gerald Wittenberg, MSc, DMD (retired) · Answer

The best approach is a genioplasty in your case to reduce the height of the chin while improving the profile projection. There are really few risks of the genioplasty in experienced hands and the result is more permanent and natural than an implant in that area.

Sliding Genioplasty Vs Chin Implant

Answers (11)