Chin Narrowing (Desquaring the Wide Chin)
A large or prominent chin is a distinct male feature and is one the most important changes to make for a more feminine lower face. In determining the type of chin reduction procedure needed it is important to determine the dimensional changes required for the desired effect. In some chin shapes the horizontal projection and vertical length are fine but the chin is too wide. For this chin shape change the corners of the chin are removed with a reciprocating saw through an intraoral approach. (lateral tubercle reduction) This is the one chin reduction procedure where bone burring from an intraoral approach can be effective.
Chin Length and Width Reduction
Often, however, more than one dimension of the chin needs to be changed. To reduce the vertically long and wide chin, an intraoral t-shaped genioplasty is performed where horizontal and vertical sections of bone are removed and the chin reassembled with small plates and screws. If a horizontal deficiency chin exists as well the reassembled chin bones can be made to add increased horizontal projection as well. This can be a very favorable change for the patient seeking a more tapered chin shape from the frontal view.
Chin Projection Reduction
The most challenging chin reduction to perform is when it is vertically long, wide and sticks out too far. (too much horizontal projection) Getting adequate horizontal reduction of the chin, along with the other dimensions must take into account what will happen to the soon to be excessive soft tissue chin pad. Only one chin reduction approach can satisfactorily reduce all three dimensions of the chin bone and remove the excess soft tissue as well…the external submental approach where a soft tissue excision and chin tuck can be performed at the same time.
Dr. Barry Eppley