Would I benefit from a sliding genioplasty or chin implant? Would like a better profile with more chin (photos)

Question

I'd like a better profile with more of a chin. Would a chin implant be sufficient or would sliding genioplasty be better for improving aesthetics? It's also sometimes difficult to keep my lips closed when laying down, which I've read genioplasty can help with, but am not sure it's worth the risks

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this.

We can place a chin implant, which is a quick surgical procedure. Many of my patients try to avoid surgery, however, so for those patients, we also offer non-surgical chin augmentation with injectable fillers. Fillers like Radiesse, Voluma, BellaFill, and Sculptra are injected into the area to improve the overall appearance of the lower face and balance the jaw and lip harmony. We use cannula injections to meticulously contour and project the chin, soften the chin along the jawline, and improve the chin crease.

Implants are a great option once you are ready for permanent chin enhancement.​ I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Donald Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. Chin augmentation is an excellent option for improving the appearance of a weak or recessed chin. With a custom-fit chin implant, the side profile can be improved and the facial proportions brought into balance. If you’re unsure about surgery at this time, nonsurgical augmentation with a combination of dermal fillers and collagen stimulators can add volume to the chin and produce a similar, short-term effect. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or expert injector. They will be able to discuss your concerns and aesthetic goals with you and help you decide on the best course of action.

Michael P. Morrissette, DDS, FACS · Answer

I perform both procedures and I will describe my selection criteria for each procedure. When the chin is recessive by more than 5 mm I generally recommend a sliding genioplasty especially in women. It appears that you are recessive by 7-8 mm. A chin implant can make the chin appear wider which is not a benefit in women. When the amount of recession is 5 mm or less a chin implant is fine in most cases. In your case, a sliding genioplasty is most likely going to help with lip incompetence. The surgery is performed in our office with intravenous sedation and takes about an hour. The risk of complications is the same for chin implants. Be sure to consult with a surgeon who performs these procedures on a regular basis.

William Portuese, MD · Answer

A sliding and genioplasty is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay, and is much more invasive. Placement of the chin implant is done under local anesthesia which takes approximately 30 minutes in the office setting. if your teeth are significantly out of alignment, then consider the sliding genioplasty. If you're just looking for cosmetic improvement, then do a chin implant

Mats Hagstrom, MD (license on probation) · Answer

You are an excellent candidate for chin augmentation using an implant or sliding genioplasty. both procedures have certain advantages and disadvantages. The procedure can be performed by both oral surgeons and plastic surgeons. from what I see it seems that oral surgeons tend to be more in favor of the sliding genioplasty and plastic surgeons tend to lean more towards placing implants.
Oral surgeons are after all primarily trained in facial skeletal surgery while plastic surgeons tend to be more focused on soft tissues.
It simply depends on what each provider feels is the better approach which often has to do with your training, personal experience etc. etc.
I always recommend patients have multiple consultations for any cosmetic surgical procedure.
All cosmetic surgical procedures have a variety of outcomes and finding the most talented and experience provider in your community is the best way of having the entire experience be a positive one.
To minimize the chance of needing revisions or having complications, or undesirable outcomes patients should be very selective and vet providers thoroughly.
Start the process by scheduling multiple in person consultations. In your case I would recommend consulting with both oral surgeons and plastic surgeons in your community.
You’ll hear firsthand what each provider has to say. Oral surgeons are also better educated and trained in all the various mandibular surgical procedures including assessing dental occlusion and other variables that may be overseen by those who are more soft tissue focused.
There are also plastic surgeons who have craniofacial fellowship training similar to what oral surgeons go through.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures. being shown a handful of preselected pictures which most likely represent the best results of the providers career is insufficient to get a clear understanding of what average results look like or how many of these procedures a provider has actually performed.
Ask the provider to show as many pictures as possible of patients who have very similar facial characteristics to your own. ask the provider to show examples of excellent outcomes, average outcomes and less than outcomes. Ask them what the revision rate is and what the revision policy is.
All plastic surgeons and oral surgeons as well should have a certain revision rate. it varies somewhat from procedure to procedure but overall I think 5% is a healthy revision rate.
In your case it appears that your overbite is relatively mild and you have an obtuse Labiomental angle. This is in a sense the perfect set up for augmenting your chin whether you choose an implant or sliding genioplasty. you can probably tolerate a substantial advancement with good aesthetic outcome.
Choose the right provider and you should look forward to a nice transformation.
Best,
Mats Hagstrom MD

Gerald Wittenberg, MSc, DMD (retired) · Answer

yes, a genioplasty is best since your jawline has a higher slope and it can be altered 3 dimensionally with a genioplasty. The lip competence does tend to improve as well, but there are other factors that are involved.

Would I benefit from a sliding genioplasty or chin implant? Would like a better profile with more chin (photos)

Answers (6)

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