Do you want to learn more about how chin advancements (genioplasties) are performed?

We understand that helpful information can be hard to find.

This post provides illustrations that show how chin advancements (genioplasties) are performed, with several illustrations.

The post was written by an Ear, Nose, and Throat (ENT)/sleep surgeon.

Chin advancement with plates and screws shown holding the bone in the new position. CamachoMD.com
Chin advancement with plates and screws shown holding the bone in the new position.

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Summary for chin advancement (sliding genioplasty):

Chin advancement surgery (also known as sliding genioplasty) is when the front part of the lower jaw (mandible) is moved forward.

The procedure is usually performed for either obstructive sleep apnea or for cosmetic reasons. 

A person who has a chin that is small could be a good candidate.

By moving the chin forward the patient can have a stronger chin after the surgery. 

When chin surgery includes the genial tubercle, then the surgery can help improve the size of the upper airway by moving the tongue forward.

What is a chin advancement (sliding genioplasty)?

The lower jaw (mandible), has multiple sub-components. The components include the ramus (left and right) and the body which is located between the right and left ramus.

The chin is the front part of the body.

Small chin with the inferior alveolar nerve and mental nerve shown in yellow. CamachoMD.com
Small chin with the inferior alveolar nerve and mental nerve shown in yellow.

How is a chin advancement (sliding genioplasty) performed step by step?

There are two main ways to perform the procedure:

  • The bone of the body (the chin) can be cut in a manner that does include the genial tubercle, or
  • The bone of the body (the chin) can be cut in a manner that does not include the genial tubercle, or
Small chin. The dashes mark the location where the bone will be cut to move the chin forward (sliding genioplasty). CamachoMD.com
Small chin. The dashes mark the location where the bone will be cut to move the chin forward (sliding genioplasty).

If the genial tubercle is included in the advancement, then likely the procedure is being done as a technique to help improve obstructive sleep apnea.

If the genial tubercle is included in the surgery, then the cut on the bone (osteotomy) is made higher than it is if the genial tubercle is not included as part of the surgery.

Chin advancement when viewed from the side. Note the bone was cut and was slid forward. CamachoMD.com
Chin advancement when viewed from the side. Note the bone was cut and was slid forward.

For the description, we will discuss the cutting so that it is made to include the genial tubercle.

The x-rays are reviewed.

The surgeon either measures the site to be cut or uses a prefabricated template to guide the cuts that are to be made.

The saw is brought in and the cuts are created through the oral incision.

The bleeding is stopped.

If there is persistent bleeding from the bone, then bone wax might be used.

The chin that has been cut is then pulled forward and is secured by using plates and multiple screws.

Sliding genioplasty with the bone advancement and the plates and screws holding the bone in the forward position. CamachoMD.com
Sliding genioplasty with the bone advancement and the plates and screws holding the bone in the forward position.

When should chin surgery (sliding genioplasty) include the genial tubercle?

If a patient has obstructive sleep apnea, then including the genial tubercle may be a good idea. Since the genial tubercle is where the genioglossus muscle is attached, by moving the genial tubercle forward, the airway is opened more compared to not including the genial tubercle.

Sliding genioplasty. In this case, the cut of the bone included the genial tubercle. There are plates and screws in place, holding the bone forward. CamachoMD.com
Sliding genioplasty. In this case, the cut of the bone included the genial tubercle. There are plates and screws in place, holding the bone forward.

Another option for chin surgery is a genial tubercle advancement which is when a rectangular bone window is made in the front part of the chin (measuring about 1 centimeter by 2 centimeters).

When the genial tubercle advancement is completed, the bone window is pulled forward and the tongue moves forward too since the genioglossus muscle is attached to the genial tubercle.

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