CPT® Code 21122

Genioplasty is a surgical procedure aimed at correcting the bony contour of the chin through the technique of sliding osteotomy. This procedure is particularly beneficial for patients with asymmetrical chins, where the chin may be either receding or protruding. The surgery begins with an incision made in the gingivolabial sulcus, which allows 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 laterally from the midline of the chin until the mental nerves, which are responsible for sensation in the lower lip and chin, are identified and preserved. The placement of the bone cuts is carefully determined based on the specific needs of the patient. The mandible, or lower jawbone, is then cut on each side using a sagittal saw, allowing for precise adjustments to the chin's position. Depending on the patient's condition, the chin may be advanced (moved forward) or retruded (moved backward) to achieve the desired aesthetic outcome. Once the bone is repositioned, it is secured in place using wires or a plate and screw device to ensure stability during the healing process. Finally, the overlying soft tissues are meticulously closed in layers to promote optimal healing and minimize scarring. This procedure is distinct from other types of genioplasty, such as a single piece sliding osteotomy, which involves fewer bone cuts, and is specifically indicated when multiple cuts are necessary for reshaping an asymmetrical chin.