Sliding Genioplasty

A sliding genioplasty is a very effective option for individuals who would like to correct their chin position. It involves repositioning the chin, so that a more harmonious facial profile can be achieved.
It can be undertaken for individuals with a deficient chin or for individuals with a prominent chin.

A sliding genioplasty, in my experience is more often undertaken to address a deficient chin.
While there are various causes for ending up with a deficient chin, the most common cause
is a basic underdevelopment during growth. A deficient or retruded chin can often lead to
an overly convex facial profile, making the teeth and nose appear more prominent.

It is important that the bite (dental occlusion) is also considered in determining whether you are a good candidate for a sliding genioplasty, as in some cases, additional jaw surgery may be indicated to correct the entire jaw, rather than just the chin.

Chin implant vs Sliding genioplasty?

Both procedures offer a solution to addressing a deficient chin. The decision to choose one over the other ultimately depends upon a few factors, such as:

  • The amount of chin advancement required
  • Longevity of the results
  • The potential complications with each option
  • Surgeon expertise
  • An individual’s preference

All of the above factors will be discussed with you in details at the time of your consultation, so that a final decision can be made in an informed manner.

In very basic terms the fundamental difference is that a sliding genioplasty involves advancing the chin bone itself, whilst a chin implant involves inserting a silicone implant just in front of the bone. A sliding genioplasty can therefore be considered a permanent correction.

The table below will serve as a guide to help making a decision. Again, all of these factors require a further in-depth consultation with Dr Reddy, as they will not be applicable to all cases. An individualized approach needs to be taken in all cases.

CHIN IMPLANTSLIDING GENIOPLASTY
LONGEVITY*NOT PERMANENTPERMANENT
DURARTION OF SURGERY1-1.5hrs2-2.5hrs
SILICONE IMPLANTYESNO
INCISIONINSIDE THE MOUTH OR UNDER THE CHININSIDE THE MOUTH
ADVANECEMENT GREATER THAN 1cmMAY REQUIRE A CUSTOM- MADE IMPLANTYES
CORRECT ASSYMMETRYLESS LIKELYMORE LIKELY
DOES THE CHIN REGRESS BACK AGAIN?MAY DO SO OVER TIMEGENERALY NOT
CAN THE CHIN SHIFT SIDEWAYS UNWANTEDLY?YESEXTREMELY UNLIKELY
WILL THE FULLNESS UNDER MY CHIN IMPROVENOOFTEN
CAN I ALSO REDUCE A PROMINENT CHIN PROMINENT CHIN
NO
YES

 

* Implants being synthetic products are not considered permanent. Implants can however stay in place for several years. A sliding genioplasty is generally considered permanent, although revision surgery may be required if complications with the hardware or bone healing results.

As a Reconstructive and Cosmetic surgeon, I think it is important to be able to offer both options to patients. I find that in many cases, a sliding genioplasty is not offered to patients due to reservations or inexperience of the previously consulted surgeon. A sliding genioplasty is a technically more difficult procedure, but when done correctly can provide patients with a long-lasting definitive improvement in their chin profile.

How is a sliding genioplasty performed?

Because of Dr Reddy’s dual qualifications in Plastic & Reconstructive Surgery and also Dental surgery, he will be able to discuss a specialised treatment plan with you. A 3D imaging system can also be incorporated into your treatment planning process so that you will be able to see not only the expected amount of chin bone repositioning, but also the expected overall change in your facial profile. The following images provide an example of the 3D imaging that can be used to optimise the accuracy of your surgery.

Once the treatment plan and the amount of ‘slide’ (chin movement) is determined, your surgery will be booked.

The surgery is undertaken in hospital under general anaesthesia and will take approximately 2-2.5 hours. A small incision is made inside the mouth, just behind the lower lip. The front surface of the chin and lower jaw is identified, and a custom-made guide is inserted to confirm the position of the bone cuts. The chin bone segment is then freed up, repositioned to its new position, and secured into place with a small plate and screws. Dissolving sutures are used to close the wound. A crepe wrap will be applied around the chin to reduce swelling and bruising.

Routinely you will stay in hospital for one night. Dr Reddy will review you prior to your discharge from hospital, where by you will generally be comfortable with oral analgesia medication.

What is the recovery time?

Allow for approximately 1-2 weeks recovery time. Swelling and bruising generally subsides over this time frame. Whilst you may feel capable of doing all of your usual activities, it is important that you take rest during this period to allow healing to proceed in an
uncomplicated manner. Good oral hygiene with regular mouthwashes are also important
Page 6 of 11 during this initial healing period.

What are the possible risks?

All surgery carries risks, and Dr Reddy will discuss these with you at the time of your consultation. Risks can relate to the bone properly healing after repositioning or can relate to the sensory nerves and soft tissues that surround the bone. The changes are often temporary but in a small number of cases, they can be long lasting.

When will I see my results?

The change in chin position will be immediately apparent. There will however be initial swelling that can mask some of the results. A much better idea will be apparent at the 2- week post-operative mark, but it can take up to 3 months to see the final result.

How much change can I expect from a sliding genioplasty?

Significant changes in chin position can be achieved with sliding genioplasty. Advancements greater 1cm (which is often the limit with chin implants) can be achieved. Further advancements can be achieved but may require supplemental procedures such as bone grafting to achieve this.

Are the results permanent?

The results are generally considered permanent. Slight changes in profile can however occur over the years, but this is usually due to changes in the bone and soft tissues that occurs as a part of ageing process, rather than changes related to the sliding genioplasty itself.

Can it be combined with other procedures?

Ideal chin position is routinely assessed in combination with one’s other facial features. Typically, the ideal chin position is determined, based on specific measurements relating to the nose.

Sliding genioplasty is therefore often combined with rhinoplasty surgery, so that a harmonious facial profile can be achieved. A common combination entails reducing prominent nose and advancing a deficient chin forward. This will have the effect of correcting an overly convex facial profile.

Sliding genioplasty can also be undertaken to reduce a prominent chin, particularly when undertaken as part of facial feminisation surgery. Reducing an over projected chin can lead to a more feminised and softer appearance.