What Is The Best Way To Fill in The Step Offs from a Large Sliding Genioplasty?

Q: Dr. Eppley, I am a 29 years old male who is going to have a sliding genioplasty (8-10 mm horizontal projection) next week.I am very concerned about the large step off areas located both superior and posteroinferior parts of my advanced distal chin fragment.I know that their occurence will be inevitable because of my large horizontal advancement(8-10 mm).

My question is that

Can we get a fully filled up smooth bone contour by properly grafting those two step off area bone gaps (particulary the one locating at the inferoposterior area of my chin) with allogenic bonny grafts like hydroxapatite which will be replaced by my own bone?

Thanks for answering.You are the most skilled plastic surgeon I have ever seen.

A: With a low angled and long osteotomy cut there is usually no significant step offs in my experience with 10mm+ sliding genioplasties. But for the sake of this discussion you are askng about grafting them should they occur to which I can say the following:

1)  Hydroxyapatite is a ceramic calcium phosphate material which does not turn into bone….but it doesn’t have to as a permanent bone void filler material.

2) Allogeneic or cadaveric bone chips have the potential to allow bone ingrowth…although it is usually not robust or complete.

Dr. Barry Eppley

World-Renowned Plastic Surgeon