Will My Sliding Genioplasty Need Vertical Lengthening?

Q: Dr. Eppley, I’m interested in a sliding genioplasty. My occlusion or bite is fine( as far as I know and have been told.My chin has never been operated on or i.e. a virgin chin that I think needs only minimal to moderate changes in order to harmonize and balance my face. 

Having said that;I think I have a mild to moderate short face syndrome as evidenced by these pics taken by max surgeon on Sep 2024. He claims I have no vertical deficiency at all based on his software but he agrees that I have about a 4 to 5 mm horizontal deficiency.

It’s confusing and frustrating because about 9 years ago another max surgeon did no cephalic study but just eyeballed me during the consultation and confidently proclaimed 4mm to 5mm horizontally but about 8mm to 10 mm on the vertical but he also said he would back the estimate it with a study.

What do you think? I’m just trying to be logical, prudent and practical here.

A:Like all aesthetic issues it is what the patient perceives,  not what numbers/measurements or a doctor says is so. From that perspective I like to dive into imaging and see how the patient responds to some changes. (see attached chin augmentation changes which includes vertical lengthening) One can debate about about how much vertical lengthening is desired and how to do it…but that is not initially relevant. The first step is to determine if any amount of vertical chin lengthening is desirable from your perspective.

Dr. Barry Eppley

World-Renowned Plastic Surgeon