Sliding Genioplasty — moving the chin bone itself, with precision.

Sliding genioplasty is a bone-cutting procedure that repositions the patient’s mandibular symphysis to change projection, height, or lateral position. A chin implant augments soft-tissue support with a synthetic material without moving the native bone. Osteotomy allows multi-planar change — for example, simultaneous advancement and vertical lengthening — while implants are simpler but limited when skeletal vectors or asymmetry are primary concerns. Final candidacy requires in-person assessment, including occlusal review and imaging.

Candidacy depends on skeletal alignment, soft-tissue quality, prior surgeries, and patient goals. Sliding genioplasty is favored when multi‑planar correction, long-term skeletal support, or significant asymmetry is needed; implants may suffice for isolated, modest projection deficits. Medical factors such as smoking, systemic health, and dental status are considered; skeletal maturity is required. Dr. Mourad reviews dental records and imaging in consultation to determine the most appropriate option.

Planning begins with a clinical exam and standardized photography, followed by dental and occlusal assessment; CBCT or cephalometric imaging is obtained when indicated. Digital simulation can model osteotomy vectors and predicted soft‑tissue relationships to refine the surgical plan. When orthodontic or orthognathic input is needed, records are coordinated with your dental specialists. The operative plan is individualized; final movement magnitudes and fixation choices are confirmed at the preoperative visit.

The mental nerve is identified and protected throughout the intraoral dissection and osteotomy to minimize traction or compression. Temporary lower‑lip and chin numbness is common and typically improves over weeks to months, with most patients reporting progressive return of sensation by 6–12 months. Persistent altered sensation is uncommon but possible; the risk is discussed during consent. Revision cases or complex lateral shifts can increase the likelihood and are managed with heightened surgical caution.

Initial swelling and tightness are greatest during the first 48–72 hours and gradually improve over 2–6 weeks. Most patients return to office-based work within 1–2 weeks depending on job demands and visible swelling. Subtle residual swelling and contour refinement continue for 3–6 months; final contours are typically appreciable by 6 months. Activity restrictions, wound care, and follow-up visits are tailored at the postoperative appointment.

Yes. Osteotomy allows controlled lateral translation and rotational adjustments to address asymmetry, as well as vertical advancement or shortening to change chin height. The procedure can correct combined three‑dimensional deformities that would be difficult to address with an implant alone. Complex asymmetry planning often uses 3D imaging and may be staged or combined with other procedures for optimal occlusal and facial balance.

Genioplasty can be combined with septorhinoplasty or orthognathic procedures when coordinated planning supports functional or aesthetic goals. Combining procedures may improve overall facial harmony and reduce total operative occasions, but it requires careful coordination of airway, occlusion, and recovery logistics. When major jaw movements are planned, orthodontic preparation or a staged approach is often necessary. Surgical decisions are individualized and made after multidisciplinary review when indicated.

Rigid fixation with titanium plates and screws stabilizes the osteotomy and is well tolerated in most patients, providing durable skeletal support. Plates are typically left in place indefinitely unless they cause symptoms such as palpable irritation, infection, or contour concern; removal is uncommon but possible, usually after bone healing at 6–12 months. Hardware can occasionally be felt through thin soft tissue, which is discussed preoperatively. The presence of standard fixation hardware does not routinely interfere with dental care or imaging.

Revision planning requires review of prior operative notes and imaging when available, because existing scar tissue, capsule, or implant position alters exposure and osteotomy strategy. Options include removal of the implant with immediate osteotomy, staged removal then bone surgery, or combined implant exchange in selected cases. Revision scenarios raise complexities such as altered anatomy and higher rates of soft‑tissue adherence, so individualized planning and informed consent are essential. Dr. Mourad discusses expected tradeoffs and timelines during consultation.

Recognized risks include temporary or persistent sensory change of the lower lip and chin, infection, bleeding, tooth-root or dental-pulp injury, malposition or under/overcorrection, asymmetry, contour step-off or inferior-border notching, wound dehiscence, nonunion, bone resorption or relapse, hardware irritation, chin-pad (mentalis) ptosis, and the possibility of revision surgery. Careful osteotomy planning below the tooth roots and mental foramina, low-profile fixation, and precise mentalis closure are the principal safeguards. Any concern after surgery is evaluated promptly at follow-up.

Soft-tissue chin ptosis can occur if the mentalis muscle and chin-pad attachments are excessively released or inadequately restored. Careful soft-tissue preservation and precise mentalis reapproximation help reduce this risk. Revision may be required when significant ptosis or lower-lip malposition occurs.

Advancement genioplasty can change tongue-base, hyoid, and airway relationships in selected patients, but isolated cosmetic genioplasty should not be considered a primary treatment for moderate or severe obstructive sleep apnea. Patients with suspected sleep-disordered breathing need formal sleep evaluation, and orthognathic or other airway treatment may be more appropriate.