A Simplified, Reliable Approach for Advancement Genioplasty

Abstract

A dvancement genioplasty, compared with alloplastic implantation, can provide both functional and aesthetic benefits for the patient. 1-5 Yet, despite numerous modifications and progress in advancement genioplasty, 6-11 facial plastic and plastic surgeons, unlike oral maxillofacial surgeons, seldom use this technique. 12,13 Much of the present literature about advancement genioplasty is found in oral surgery journals. It is likely that facial plastic surgeons' comfort and familiarity with alloplastic implants contributes to their more widespread use of these implants than of advancement genioplasty. Although an alloplastic chin implant is faster and easier to perform than an advancement genioplasty, it can produce complications, including infection, chronic inflammation, extrusion, variable bone resorption, capsular contraction, displacement, and chin ptosis. 3,14 Some have reported that advancement genioplasty allows for the correction of more complicated deformities, provides greater patient satisfaction, permits heightened predictability, and provides greater stability than alloplas-tic implantation. 3,5,13 We believe that advancement genioplasty is a valuable tool for the facial plastic surgeon in offering both aesthetic and functional benefits for the patient. In the present study, we describe a safe, reliable, and effective method for the osteotomy performed in advancement genioplasty and our results using this technique during the past 17 years. Methods The John Peter Smith Hospital Institutional Review Board approved this retrospective study of medical records of patients who had undergone advancement genioplasty. Patients were included in the review if they underwent an advancement genioplasty from September 1997 to September 2014, using the technique described below. Patient medical records were reviewed between January and March 2015. Patient demographic data, indications for advancement genioplasty, and IMPORTANCE Advancement genioplasty is a versatile procedure able to address both functional and cosmetic issues. It is commonly performed by oral surgeons and less so by facial plastic and plastic surgeons, presumably because of its inherent risks. OBJECTIVES To present our technique for advancement genioplasty and our aesthetic and functional outcomes. DESIGN, SETTING, AND PARTICIPANTS A retrospective review was conducted of the medical records of 126 patients who had undergone advancement genioplasty with our modified technique in a private practice setting from September 1997, through September 2014. Our analysis was performed between January and March 2015. MAIN OUTCOMES AND MEASURES Description of technique and evaluation of complication rates, improvement in sleep apnea symptoms, and patient satisfaction. RESULTS The 126 patients had a mean age of 39.8 years. There were 81 male and 45 female patients. The overall complication rate was 6.3% (8 of the 126 patients). Complications included plate extrusion in 2 patients, infection in 2 patients, mental nerve injury in 3 patients, and tooth root injur...

A retrospective analysis of dentofacial deformities and orthognathic surgeries

“…Indeed, manipulation of the sliding segment in genioplasty allows for corrections of the horizontal, vertical, and transverse chin abnormalities, making genioplasty a very versatile technique. [ 22 ] However, reports suggest that many plastic surgeons, unlike oral maxillofacial surgeons, use alloplastic implants for chin augmentation genioplasty as it generally requires less operative time and is easier to accomplish,[ 22 ] despite various reported complication such as infection, chronic inflammation, extrusion, bone resorption, capsular contraction, displacement, and chin ptosis. [ 22 ]…”

Genioplasty and Mandibular Implants

“…While mandibular implants can achieve aesthetic goals, it is unable to offer any functional benefit for patients, particularly those with sleep apnea. [40][41][42][43][44] Furthermore, alloplastic implants can be complicated by infection, chronic inflammation, extrusion, bone resorption, capsular contraction, displacement, and chin ptosis. 40,45 Advancement genioplasty may also be more beneficial in patients with more complex deformities and yields more predictable and stable results.…”

“…40,46,47 Various authors recommended osseous genioplasty due to its versatility, predictability, stability, and low complication rates. 43,44,[48][49][50] In addition to the aesthetic improvements of sliding genioplasty, various authors have also shown how it can be used to improve obstructive sleep apnea as well. 44,[51][52][53][54] In experienced hands, Gui et al showed that osseous genioplasty yielded no malunions or nonunions in their 500 patient cohort.…”

Chin Reshaping in Profileplasty: Augmentative and Reductive Strategies

“…While viewed by some as a highly invasive operation, it is the easiest to learn and master of all the "craniofacial bone surgery" techniques. 6 The term "sliding genioplasty" is how this bony chin operation is most commonly referred to as. But this is an archaic and inaccurate term today as to how the operation is done and used.…”