The sliding genioplasty is a common chin augmentation procedure that is well known. While highly effective at making horizontal and vertical dimensional changes to the chin, the ideal augmentation amount may not always be achieved. Just like that of chin implants picking the amount of horizontal chin increase is not an exact science.
In desiring more horizontal augmentation after a sliding genioplasty there are two options…recutting the bone and moving it further forward or adding an implant onto the front of the bone. There are advantages and disadvantages to either approach and the patient will ultimately decide what one is most appealing to them.
Adding an implant onto the prior advanced chin bone offers an easier recovery than a secondary sliding genioplasty. Coming from a submental approach is particularly appealing to some sliding genioplasty patients because it avoids the intraoral incision and its more prolonged recovery. The existing metal hardware is irrelevant, although it can be removed if one so desires, and the implant can be place on top of it. The hardware provides a convenient anchor for suture fixation of the implant.
There is always room for a little more augmentation even on the end of a sliding genioplasty. The chin pad can be mobilized off the bone and a spacer (implant) placed. This pushes out the soft tissue chin pad which can also have some positive change to the immediate submental area.
I have read that some doctors/patients say that an implant after a sliding genioplasty can not be done for reasons that are usually not provided. This is clearly not an accurate statement in my experience.
Dr. Barry Eppley