The sliding genioplasty is a well known chin augmentation that is most commonly performed in younger male and female patients. Besides the greater invasiveness of the procedure what really separates it from a chin implant is its effects on the submental or anterior neck region. By pulling the chin bone forward the attached soft tissues to its underside and posterior surface stretches out the neck tissues which improves a submental fullness and any loose anterior neck skin. How significant those soft tissue effects are is influenced by the amount of horizontal advancement that is done.
Disproportionately so bony genioplasties are performed primarily in patients in the 18 to 35 year old age group. As patients get older in their 40s and 50s it is far less commonly done and, unless there are other dimensional needs (vertical height increases or decreases), most horizontal augmentations are done with an implant. Experiences in older patients are far more limited but the aesthetic soft tissue benefits on the surrounding tissues may be more pronounced.
In the advanced article section of the July 2022 issue of the Aesthetic Surgery Journal, an article was published on this topic entitled ‘Incorporating the Osseous Genioplasty Into Rejuvenation of the Lower Face’ In this paper the author’s review their ten-year experience with performing a bony genioplasty in almost forty (37) patients with an average age of 45 years, most of which were female. (70%) Of this group about one-third (30%) have the procedure performed in isolation. About 20% of the patients had rejuvenated procedures of liposuction, platysmaplasty and facelift performed concurrently.
Bony genioplasties can be an effective procedure in older patients but they often are a bit more apprehensive to undergo it unless they have a major chin/lower jaw deficiency. Older patients that represent for facial rejuvenation as their primary motivation with a mild to moderate chin deficiency are far more likely to find an implant more appealing in most cases. There are unquestioned benefits as it relates to how much better the neck looks with increased lower facial projection and improvements in submental/submandibular tissue laxity and even some tightening of the surrounding perioral tissues.
Dr. Barry Eppley
Indianapolis, Indiana