Sliding genioplasty

Overview 

Sliding genioplasty, also known as osseous genioplasty, is a surgical procedure designed to enhance facial symmetry and alignment by reshaping the existing chin bone. This technique addresses various concerns, including chin protrusion, recession, or misalignment.

Sliding genioplasty allows for precise adjustments to the chin’s position, enabling it to be moved forward, backward, or sideways. This is particularly beneficial for individuals with chins that are too far back, too far forward, excessively long, too short, or not in harmony with their other facial features.  

While both sliding genioplasty and chin implants aim to improve chin appearance and facial balance, they differ in approach. A chin implant involves inserting a silicone implant to increase definition and size in a small chin, thus enhancing the lower face and jawline.  

Reasons for undergoing the procedure  

Ideal candidates for sliding genioplasty are those who are in good overall health, have completed skeletal growth, do not smoke, do not have underlying jaw disorders, and maintain realistic expectations regarding surgical outcomes.

Most individuals undergo sliding genioplasty primarily for cosmetic enhancement, but the procedure is also utilized for reconstructive purposes following trauma, such as facial fractures, or to address congenital anomalies.

Conditions that may be treated with a sliding genioplasty include:  

• Recessed jaw, or retrognathia  
• Receding chin, or retrogenia  
• Small or underdeveloped chin, or microgenia  
• Uneven chin alignment, characterized by a chin that is off-center and not aligned with the middle of the face  
• Abnormal chin length, characterized by a chin that is either too long or too short  
• Forward-protruding chin, or prognathia  

Risk 

Similar to any medical procedures, a sliding genioplasty carries certain complications, such as:  

• Numbness or tingling in the lower lip or chin  
• Infection  
• Scarring  
• Bleeding  
• Bruising  

Before the procedure  

Before a sliding genioplasty, the healthcare provider will conduct imaging scans of the chin and jaw to plan the procedure, perform a physical exam or blood tests to confirm the one’s overall health.  

Specific instructions are given, such as:  

• Discontinuing certain medications like aspirin, anti-inflammatory drugs, or herbal supplements  
• Taking antibiotics to reduce the risk of infection  
• Quit smoking several weeks prior to surgery  

During the procedure  

During a sliding genioplasty, these may be expected:  

• General anesthesia is administered to ensure that one is unconscious and do not feel pain during the procedure.  
• A horizontal incision inside the mouth at the base of the jawline is made, so the scar remains hidden.  
• Using a surgical saw, the healthcare provider cuts part of the chin bone in a procedure called an osteotomy.  
• Depending on the desired outcome, the cut bone is moved forward, backward, or sideways. To shorten a long chin, a piece of the bone is removed, and to lengthen a short chin, a gap between two pieces of bone is created.  
• The repositioned bone is secured using wires, plates, or screws to maintain the new alignment.  
• The incision inside the mouth is closed with dissolvable stitches.  
• A tape-like surgical dressing is applied inside the mouth, and an additional supportive dressing may be placed externally under the chin.  

After the procedure  

The healthcare provider will give detailed instructions for caring for the incision, highlighting the importance of not disturbing the surgical dressings or any stitches located inside the mouth. Typically, dressings are removed after 3 to 4 days, and the stitches will dissolve naturally within a few weeks. Most patients can return home on the same day as their surgery, although some may require an overnight stay in the hospital.   

Outcome 

Sliding genioplasty enhances facial balance and symmetry while addressing chin issues resulting from birth defects, injuries, or previous surgeries.

During the recovery phase, it’s crucial to monitor for potential complications and seek immediate medical attention if any of the following symptoms occur:  

• Irregular heartbeat or unusual pulse  
• Difficulty breathing (dyspnea)  
• Chest discomfort  
• Elevated temperature, shivering, or flu-like symptoms  
• Persistent swelling or pain lasting beyond a few weeks  
• Signs of infection, such as pus or discharge from the incision site

Swelling and bruising are normal and may last for up to two weeks. Discomfort is typically mild and can be managed with over-the-counter pain relievers and cold compresses. 

The healthcare provider may also suggest the following:  

• Follow a liquid or soft-food diet to prevent irritation to the incision or disruption of stitches  
• Rinse the mouth with salt water before and after meals to keep the incision clean  
• Sleep with the head elevated to reduce swelling in the chin and lip  
• Avoid strenuous activities for a few days