9704-1273 Wider
Wider TM, Spiro SA, Wolfe SA.
Simultaneous osseous genioplasty and meloplasty.
Plast Reconstr Surg. 1997 Apr;99(5):1273-81. PMID: 9105353
Division of Plastic and Reconstructive Surgery, University of Miami School of
Medicine, Fla, USA.
A review was done of the records of 50 patients who had osseous genioplasty
performed at the same sitting as face lifting and, in many cases, submental
lipectomy over a 20-year period by the senior author. The types of genioplasties
were sliding advancement (40), lengthening with interpositional bone graft (7),
and reduction (3). In 9 patients, chin implants were removed, generally because
of inadequate chin projection or implant erosion. Three patients were operated
on under local anesthesia, the remainder under general anesthesia. Associated
procedures, done in 46 patients, included rhinoplasty, forehead lifting,
blepharoplasty, lateral canthopexy, excision of buccal fat pads, reduction
mammaplasty, and abdominoplasty. In 4 patients, associated maxillofacial
procedures were performed, including Le Fort I and III osteotomies, two-jaw
surgery, mandibular advancement with sagittal splitting, and orbital expansion.
The perceived advantages of osseous genioplasty were greater versatility in
dealing with problems in other than the sagittal plane, the possibility of
greater chin projection, and a tightening of the submental musculature.
Complications occurred in 10 patients. These included two hematomas requiring
aspiration in the office, a prolapsed submandibular gland requiring later
excision, a transient weakness of the marginal mandibular nerve, a transient
numbness of the lower lip on one side, four revisions of scars resulting from
the face lifting, and one localized wound infection in the parasymphyseal area
that resolved with oral antibiotics. The most common complaint, which came from
8 female patients at some time from 1 month to 3 years postoperatively, was that
the chin was "too strong." In 6 of these patients, most of whom were operated on
early in the series, some of the chin projection was reduced by burring. Osseous
genioplasty can be performed safely along with face lifting and submental
lipectomy. The degree of advancement necessary in aesthetic surgical patients is
generally less than that required in reconstructive patients. Patient
satisfaction is great unless the chin is overly advanced.
|
