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There are a variety of dimensional changes that can be done to the bone of the chin to changer it’s shape. Historically moving the chin bone forward for horizontal augmentation and/or dropping it down for vertical elongation were the primary movements done. But the popularity of V-line surgery has introduced a new type of chin shape change…making it more narrow. While such chin narrowing surgery is how the chin is changes in an overall V-line jaw reduction, it can also be done as a stand alone procedure giving its name Mini V-Line Surgery.

Mini V-Line surgery, also known as a T-shaped genioplasty, is a combination of a horizontal and paired midline osteotomies done with the objective of narrowing the chin by removal of a vertical segment of bone. It has the advantage over simply cutting off the sides of the chin by maintaining the lateral soft tissue attachments decreasing the risk of undesired soft tissue chin pad dimpling.

Done through an intraoral approach like most bony genioplasties partial horizontal and bilateral vertical paramedian bone cuts (in this case they were separated by 6mms) are initially made. Most of the vertical cuts are made before the chin is down fractured. The vertical cuts are made almost the way through but not completely.

The horizontal osteotomy is then completed and the chin down fractured as still one piece.

Once down fractured the vertical bone cuts are completed and the central wedge mobilized. The central wedge of bone will still be attached to fibers of the genioglossus muscle which must be detached for the bone wedge to be removed.

A chin plate is modified and bent straight so its four screw holes and screws can be used to secure the two inferior bone segments together in the midline. These are then secured to the stable superior bone to complete the chin narrowing and create the T-shaped osteotomy pattern. If any small gaps between the bone segments remain that are felt to be significant small bone grafts can be placed into them.  

Dr. Barry Eppley

World-Renowned Plastic Surgeon

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