Need help with fixing botched genioplasty/step-offs that have ruined my jawline - Can anyone please advise? Thank you! (photo)

Question

I had a genioplasty done almost 10 years ago, it has left me with a huge bony bulge on my left jawline (that is not soft tissue, it's a hard bony bulge) and big notches on both my right and left jawline. The right side also has a large bulge (this one is soft tissue) just in front of the big notch. The genioplasty also left my lower lip rolled inward. I've searched around but haven't found much by way of solutions to make my jawline straight again. Can anyone please advise? Thank you!

Alejandro Nogueira, MD · Answer

I have done chin revisions but I admit your case is peculiar and difficult to understand, at least from the images posted. To begin with I'd request a 3D reconstruction CT scan so that we know exactly the kind of assembly was practiced there; as you well point out there are bulges, clefts and odd effect in need of skeletal explanation.Probably you received an oblique osteotomy with some kind of unplanned fragmentation or deviation fom the surgical plan, but as I said all is mere speculation without a clear radiological imaging. Also the soft tissues are retracted, pinned inwards and need revision; it is strange to see such under the chin incision, if this was used for the genioplasty I must tell you the standard access is intraoral, so this adds more mistery to your case.Please provide the mentioned imaging and then I may tell you more; probably we have to reverse your genioplasty and add some bone grafting.See the link below to find few cases of my own practice very similar to yours which I had the opportunity to operate successfully on, sharing a lot of common features with the technical problem you have posted.
If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also from underneath.
Feel free to request any additional information from me.

Gerald Wittenberg, MSc, DMD (retired) · Answer

The solution is not difficult and must consider the bone contour as well as any soft tissue changes in the area. Placing contouring material along the bone and 'covering up' the defect is the main issue; and potentially changing some of the soft tissue contours at the same time is a secondary procedure. Bone irregularities do occur and it is important to always consider post-surgical healing as part of the decision process when the genioplasty is performed.

Need help with fixing botched genioplasty/step-offs that have ruined my jawline - Can anyone please advise? Thank you! (photo)

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Everything you need to know about Genioplasty

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Need help with fixing botched genioplasty/step-offs that have ruined my jawline - Can anyone please advise? Thank you! (photo)

Answers (2)

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Recommended reading

Everything you need to know about Genioplasty

Our mission is to create a world where every investment in modern beauty is Worth It.