CPT® Code 21121

Genioplasty is a surgical procedure aimed at correcting the bony contour of the chin through a technique known as sliding osteotomy. This procedure is particularly beneficial for patients who have either a receding or protruding chin, as it allows for the repositioning of the chin to achieve a more balanced facial profile. The surgery begins with an incision made in the gingivolabial sulcus, which is the groove between the gums and the lip, providing access to the underlying bone structure. Once the incision is made, the periosteum, a dense layer of connective tissue that covers the bones, is exposed. A subperiosteal dissection is then performed, which involves carefully separating the periosteum from the bone laterally from the midline until the mental nerves, responsible for sensation in the chin and lower lip, are identified and preserved. The next step involves determining the placement of the bone cuts, which are critical for the success of the procedure. The mandible, or lower jawbone, is then cut on each side using a sagittal saw, allowing for the chin to be either advanced forward or retruded backward, depending on the specific needs of the patient. After the desired position of the chin is achieved, the bone is secured in place using either wires or a plate and screw device, ensuring stability during the healing process. Finally, the overlying soft tissues are meticulously closed in layers to promote optimal healing and aesthetic outcomes. This procedure is coded as 21121 for a single piece sliding osteotomy, which involves a single bone cut on each side of the mandible, distinguishing it from other related procedures that may require multiple cuts or additional techniques.