CPT® Code 21123

Genioplasty, specifically a sliding osteotomy with augmentation using interpositional bone grafts, is a surgical procedure aimed at correcting the bony contour of the chin. 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 aesthetically pleasing facial profile. The surgery begins with an incision made in the gingivolabial sulcus, which is the groove between the gums and the lip, allowing access to the underlying bone structure. The periosteum, a dense layer of connective tissue that covers the bones, is then exposed through a subperiosteal dissection that is performed laterally from the midline. This careful dissection is crucial for identifying the mental nerves, which are important for sensation in the chin area. Once the surgical site is adequately prepared, the surgeon determines the placement of the bone cuts necessary for the osteotomy. Using a sagittal saw, the mandible is cut on each side, allowing for the chin to be either advanced or retruded based on the specific needs of the patient. After the desired position of the chin is achieved, the bone is secured in place using 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 minimize scarring. This procedure is distinct from other types of genioplasty, such as those involving single or multiple bone cuts without grafting, as it incorporates the use of autografts harvested from the patient to enhance the structural integrity and contour of the chin.