Chin reduction surgery is sought for those patinets afflicted with a chin that is too strong or protrusive. A large chin can exist in numerous dimensions, albeit being vertically too long, too horizontally forward or too wide. In many cases the chin protrusion is caused by at least two and sometimes all three dimensional excesses.
Intraoral chin reduction is reserved for a minority of large chin patients. A chin that is too vertically long can be reduced by a wedge reduction bony genioplasty. But chins that are too far forward should not be reduced by shaving or setback genioplasties. This will lead to soft tissue chin problems of redundancies and/or chin ptosis. (sagging)
A submental chin reduction is the most effective technique for a chin that needs multiple dimensional changes. It is preferred because it can deal with the resultant soft tissue excess that results from loss of bone support. It also provides direct access for reducing the jawline behind the chin along the inferior border.
The best and simplest method for estimating and planning the bone removal in a submental chin reduction is a panorex x-ray. This x-rays provides visualization of the important mental nerve as it courses through the bone.
With x-ray planning as a precise guide, the measurements can be transferred to the bone during the chin reduction surgery. This will allow the maximum amount of bone removal while protecting the integrity of the mental nerve as it courses through the jawbone.
An after surgery x-ray shows the execution of the exact bone removal plan and how close the path of the nerve is to the underlying bone cut. Comparison of the preoperative planning panorex to the result seen in the after surgery panoex shows how well the surgical bone removal was done.
The use of a panorex x-ray in submental chin reduction is a valuable presurgical tool which is of greatest importance when bone needs to be removed along the jawline behind the chin.
Dr. Barry Eppley