Category Archives: Genioplasty

Improvement of Facial Appearance and Nocturnal Breathing …

This article reports on two cases of nonobese female patients who presented in an orthodontic practice complaining of dental malocclusion and facial dysharmony. Because of the observed clinically and radiographically extreme mandibular retrognathia, they were referred for a sleep study and were found to have mild sleep apnea. Surgery in the form of advancement geniotomy was offered to relieve their retroglossal obstruction, improve their nocturnal sleep, and simultaneously address their facial esthetic concerns. Advancement geniotomy is useful for sleep apneic patients with exclusively retroglossal obstruction secondary to mandibular retrognathia.

Keywordsgenioglossus advancementadvancement geniotomyobstructive sleep apneasleep disordered breathinghorizontal mandibular osteotomy

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1.

Goldberg AN, Schwab RJ. Sleep apnea. Identifying the patient with sleep apnea. Upper airway assessment and physical examination. Otolaryngol Clin N Am 1998;31:919930

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Partinen M, Guilleminault C, Quera-Salva MA, JamiesonA. Obstructive sleep apnea and cephalometric roentgenograms. The role of anatomic upper airway abnormalities in the definition of abnormal breathing during sleep. Chest 1988;93:11991205

3.

Riley R, Guilleminault C, Herran J, Powell N. Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients. Sleep 1983;6:303311

4.

Tsuchiya M, LoweAA, Pae EK, Fleetham JA. Obstructive sleep apnea subtypes by cluster analysis. Am J Orthod Dentofacial Orthop 1992;101:533542

5.

Riley R, Powell N, Guilleminault C. Maxillary, mandibular and hyoid advancement for treatment of obstructive sleep apnea: A review of 40 patients. J Oral Maxillofac Surg 1989;47:159164

6.

Waite PD, Wooten V, Lachner J, GuyetteRF. Maxillomandibular advancement surgery in 23 patients with obstructive sleep apnea syndrome. J Oral Maxillofac Surg 1989;47:12561261

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Schwab RJ, Goldberg AN. Sleep apnea. Radiographic and other imaging techniques. Otolaryngol Clin N Am 1998;31:931968

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Schwab RJ, Gefter WB, Hoffman EA, et al. Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing. Am Rev Respir Dis 1993;148:13851400

9.

Lee NR. Genioglossus muscle advancement techniques for obstructive sleep apnea. Oral Maxillofac Surg Clin N Am 2002;14:377384

10.

Waite PD, Vilos GA. Surgical changes of posterior airway space in obstructive sleep apnea. Oral Maxillofac Surg Clin N Am 2002;14:385399

11.

Hendler B, Silverstein K, Giannakopoulos H, CostelloBJ. Mortised genioplasty in the treatment of obstructive sleep apnea: a historical perspective and modification of design. Sleep Breath 2001;5:173179

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Powell NB, Riley R. A surgical protocol for sleep disordered breathing. Oral Maxillofac Surg Clin N Am 1995;7:345356

13.

Johns FR, Strollo PJ, Buckley M, Constantino J. The influence of craniofacial structure on obstructive sleep apnea in young adults. J Oral Maxillofac Surg 1998;56:596602

14.

Riley R, Powell N, Guilleminault C. Obstructive sleep apnea syndrome: a review of 306 consecutively treated surgical patients. Otolaryngol Head Neck Surg 1993;108:117125

15.

Guyette RF, Waite PD. Adjunctive surgical procedures in obstructive sleep apnea. Oral Maxillofac Surg Clin N Am 1995;7:301310

Thieme Medical Publishers, Inc.2003

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Improvement of Facial Appearance and Nocturnal Breathing …

Sliding Genioplasty | New York, NY

The chin provides a significant aesthetic quality given to the face. When the chin is proportionate to the other facial features, the appearance is pleasing; while otherwise, a malposition chin may look far less appealing. An aesthetic proportion of the chin is obtained when the lower mandible extends as far forward as the lower lip projects. The chin is vital to balance the shape of the nose, cheeks, and other facial features. Some patients experience what is considered a retrusive chin line; this occurs when the structure of the lower jaw and chin poorly project from the face. A small, receding chin can give someone a weak and timid appearance; a first impression that is not representative of the true personality.

A Sliding Genioplasty is a less-invasive surgical procedure designed to correct a retrusive chin and achieve a more aesthetically pleasing facial structure. Most surgeons will recommend implants before a Sliding Genioplasty, however Dr. Jamali highly disagrees that implants are an easier solution. There are certain risks with placement of implants such as nerve damage, movement of the implant, scarring, bone resorption and sometimes a resulting in un-natural look. Different from other forms of Chin Augmentation, the Sliding Genioplasty procedure involves making a cut through the bone of the chin, which is called an osteotomy. By freeing up the malposition bone, Dr. Jamali is able to reposition the area to an ideal orientation. A small plate, made from titanium, is used to secure the chin in its new position on the jawbone. These plates come in varying sizes, each increasing the level of advancement. Small screws are used to permanently hold the plate in place. This simple procedure can dramatically improve the balance, proportion, and harmony of the facial features. The restored alignment of the forehead, mouth, nose, and chin will be long lasting.

Dr. Jamalis Sliding Genioplasty is an outpatient procedure, performed either in his in-office surgical suite, or at the nearby day surgery center. The surgery will take between one and two hours to complete; all patients are fully sedated through general anesthesia. Dr. Jamali will begin the procedure by making an incision inside of the mouth, on the inner portion of the lower lip, directly in front of the gum line. Once the skin and tissue has been raised aside, he will cut the chin area away from the jawbone. Next, Dr. Jamali meticulously repositions the bone, creating the desired shape and size required for the individual patient. Utilizing the innovative titanium plate and screws, Dr. Jamali permanently secures the bone in place. Over time, new bone will naturally form around this area. The incision is then closed with dissolvable sutures.

The results from a Sliding Genioplasty will be permanent and immediately noticeable. As the swelling resolves, the final appearance of the chin can be fully appreciated.

Patients who have a chin that is out of proportion with the rest of their facial features may make an excellent candidate for a Sliding Genioplasty. Patients undergoing a Rhinoplasty may be recommended to consider Chin Augmentation, to give the area an appropriate relation to the nose. A Sliding Genioplasty can also provide assistance to patients dealing with a birth defect or damage to the chin through trauma.

Both men and women, in overall good health, and do not smoke will make the ideal candidates for Dr. Jamalis Sliding Genioplasty. Patients should have realistic expectations and aesthetic goals. Depending on each individuals anatomy, there are limits on what the surgery can and cannot achieve. Before deciding on the procedure, Dr. Jamali will schedule a consultation appointment with each patient. Here he will perform a quick physical exam of the chin, review the medical history, and discuss all of the surgical options. This provides a time for patients to better understand the Chin Augmentation process, the intended results, and any possible complications. At the consultation, Dr. Jamali will determine if the patient is a good match for the Sliding Genioplasty procedure.

The recovery period after a Sliding Genioplasty is longer than compared with other types of chin implant techniques. With the ability to create dramatic changes to the chin, most patients feel it is well worth the added recovery time. Expect the recovery to take between two and three weeks. Normally, patients are able to return to work seven to ten days after surgery.

Initially, patients should expect to see some bit of swelling and bruising of the jaw. This will gradually reduce on its own, over the first few weeks. There may also be tenderness and mild discomfort. Dr. Jamali will prescribe the appropriate pain medications to allow patients to rest comfortably at home. The chin area will be covered with a surgical dressing when patients are first discharged. Over the first few days, patients may find they only have a limited ability to chew, requiring a liquid or soft food diet. As the chin heals, a normal diet can be resumed. Two weeks after the surgery, patients can add light exercise to their daily schedule, but extensive exercise and strenuous lifting should be postponed for four to six weeks.

The Sliding Genioplasty at Oral and Maxillofacial Surgery of New York is considered extremely safe and efficient. This is a simple procedure. Common complications are swelling and numbness of the lip and chin for 1-2 weeks. The best way to avoid any complications will be to choose an experienced, reputable cosmetic surgeon like Dr. Jamali, who is widely considered one of the best Sliding Genioplasty surgeons in the New York area.

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Sliding Genioplasty | New York, NY

Chin Surgery | American Society of Plastic Surgeons

Chin surgery, or mentoplasty, is a surgical procedure to reshape the chin either by enhancement with an implant or reduction surgery on the bone.

Plastic surgery, and other minor office procedures, can often be performed on the lower jaw line and chin area to improve proportions of the face and to help with one’s confidence and self-esteem. These types of interventions are frequently suggested by board-certified plastic surgeons to improve the harmony of facial features and improve the chin/jaw/cheek/forehead balance.

Sometimes bone from the jaw itself can be moved forward in an operation called a mentoplasty or genioplasty. Alternatively, shaped silicone implants can be used to give more projection to the chin. Conversely, bone can be removed to decrease an overly projecting chin. Furthermore, modifications to the upper and/or lower jaw can be advised for improved chewing dynamics and occlusionor how the teeth fit together. These operations can range from simple to very complex.

Many times a plastic surgeon may recommend chin surgery or procedures to a patient having a rhinoplasty in order to achieve better facial proportions, as the size of the chin may magnify or minimize the perceived size of the nose.

Additionally, with recent advances in technology, and after obtaining informed consent after reviewing all options, risks and benefits, your plastic surgeon may suggest off-label use of FDA approved gel filler material as an alternative for providing augmentation of the chin area that may last for a shorter duration.

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Chin Surgery | American Society of Plastic Surgeons

Chin augmentation – Wikipedia

Chin augmentation using surgical implants can alter the underlying structure of the face, providing better balance to the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of material to a patient’s chin. This can take the form of chin height reduction or chin rounding by osteotomy, or chin augmentation using implants.

This operation is often, but not always, performed at the time of rhinoplasty to help balance the facial proportions. Chin augmentation may be achieved by manipulation of the jaw bone (mandible) and augmentation utilizing this technique usually provides a more dramatic correction than with the use of prosthetic implants.

Chin implants are used to build a better profile.[1] Patients’ own bone is donated from ribs and from part of the pelvis (the ilium.) Use of donated bone implants in chin augmentation, even the patients own, appears to be associated with a higher rate of infection, even after the implant has been in place for decades.

Chin augmentation is still popular because it is a relatively easy operation for the patient while producing noticeable changes in the silhouette of the face. This type of surgery is usually performed by an oral and maxillofacial surgeon, otolaryngologist, or plastic surgeon.

The usual complications are relatively minor and include swelling, hematoma (blood pooling), weakness or numbness of the lower lip, which usually does not last long. Other, less common risks include infection, bony changes and displacement of the implant.[2] Seeking an experienced surgeon can help reduce your risks of complications.[3]

Chewing should be kept at a minimum immediately after this procedure, and patients are recommended to eat only soft food and drink for a time after the surgery.

Silicone – Silicone chin Implants are one of the most commonly used implants for chin augmentation. They are soft, smooth, flexible and come in different shapes and sizes. They do not incorporate (stick) to the surrounding tissues, so the pocket must be made precisely. They usually stay in place, but may move, buckle and cause bone resorption where they contact the mandible in some cases. Since they are smooth, they can also be removed easily.

Polyethylene – Polyethylene chin implants, brand name Medpor, are hard, porous, slightly flexible and come in various shapes and sizes. The do incorporate, as the surrounding tissues can grow into the pores of the material. This fixes the polyethylene chin implants in place, and provides a blood supply to help prevent infection. It also makes these implants much more difficult to remove.

Polytetrafluoroethylene – Polytetrafluoroethylene, brand name Gore-Tex, is used in plastic surgery and other operations is known by an abbreviation of its chemical name, ePTFE (expanded polytetrafluoroethylene) or Gore S.A.M. (subcutaneous augmentation material.)[4] Because ePTFE is flexible and soft but very strong, it is inserted during operations in trimmed sheets and carved blocks and held to the bone by titanium screws. But because the material is porous, the force that really holds the implant in place is soft tissue and bone growing through and into the implant.

The above artificial materials are used in medicine because they are biocompatible and have a low incidence of causing problems inside the human body. They are abundant, FDA cleared and can be used “off-the-shelf”, without a donor site injury to the recipient.

Acellular Dermal Matrix – ADM’s are another chin augmentation implant material. Commercially known as AlloDerm and known to physicians as acellular human cadaveric dermis, AlloDerm comes from tissue donors Just after death, technicians remove a layer of skin, remove the epidermis, and treat the remaining dermis with antibiotics and other substances to remove the donor’s cells and DNA that would cause rejection. The graft that emerges is often used to cover chin implants.

Other implant materials include Supramid, a braided nonabsorbale synthetic suture material in polymer shell and Mersiline, a mesh-like material that provides a scaffold on the bone.[5]

Surgical Chin Augmentation – The most common type of surgical chin augmentation uses a chin implant. There are many types of chin implants, and many are described in the previous section. Chin augmentation with a chin implant is usually a cosmetic procedure. An incision is made either under the chin or inside the lower lip, a pocket is made and the implant placed into the pocket. Some chin implants are fixed to the mandible, while others are held in place by the pocket itself.

Another surgical chin augmentation uses the lower prominence of the mandible as the “implant.” Known as a sliding genioplasty, the procedure involves cutting a horseshoe-shaped piece of bone from the lower border of the mandible known as an osteotomy. For chin augmentation, the piece of bone is advanced forward to increase to projection of the chin. The piece can also be recessed backward for a chin reduction. The new position is held in place with a titanium step plate using titanium screws. The bone segment can also be fixated with 26 or 27 gauge wires and IMF (wiring the jaw shut) for 3-4weeks. This type of surgery is usually performed by an oral and maxillofacial surgeon or a plastic surgeon.

More involved Orthognathic Surgery may be required in cases where the chin is small and a significant overbite co-exist. While the procedures above may improve the cosmetic appearance of the chin, they will not improve dental occlusion. Mandibular advancement surgery can be used to correct the alignment of the teeth and improve the projection of the chin.

Non-Surgical Chin Augmentation – Another method of chin augmentation uses an injectable filler. Most fillers are temporary with results lasting months to years. Common temporary fillers include hyaluronic acid and calcium hydroxyapatite preparations. Permanent fillers, like “free” silicone, have fallen out of favor due to the risk of migration, chronic inflammation and infection, which can permanently disfigure the chin.

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Chin augmentation – Wikipedia

Sliding chin genioplasty? (Photo) Doctor Answers, Tips

I want more information on a sliding chin genoplasty? Would it be recommended for me? I don’t want my chin to get any bigger I just want a longer more defined jaw and for my chin to go forward. What are the risks? How long is the recovery period and what is the recovery like? What is the average price for this procedure

You need an in-person consultation to discuss the look you have in mind and to be examined.

Always see a Board Certified Plastic Surgeon. Hope you find this information helpful Best wishes.

The concepts of moving the chin bone forward will make your jaw longer. Depending upon the amount of horizontal movement forward will determine whether it truly becomes more narrow in the front view. (which is what I think you mean by ‘well defined’. As the amount of horizontal chin movement s not substantial, the chin bone will also need to have a width narrowing procedure done on it as well. Generally it takes about 3 weeks for most of the chin swelling to resolve and one can expect some degree of chin and lower lip numbness for a few months.

Web reference: http://www.eppleyplasticsurgery.com

You might benefit more from jaw advancement than S.G. you could read more about it on the sites below.

Your images are posed with the ‘head being forward’ position and that obscures the ‘real’ position of the jaw. Try to take images with the head straight up so one can see the magnitude of the change required. The sliding genioplasty can certainly change the profile view and also the frontal view. To that end, the ‘width’ of the jaw is important to determine how much of a change is feasible to make it look natural. Recovery varies but expect a week recovery from normal activity.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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Sliding chin genioplasty? (Photo) Doctor Answers, Tips

Chin Augmentation Surgery – Augmentation Genioplasty …

Good bone structure is a major determinant of human beauty. Individuals with oversized noses often seek surgery to restore harmony among skeletal features and improve facial beauty. After nasal surgery, perhaps the next most commonly performed surgical modification of the facial skeleton is chin augmentation. In fact, large noses and small chins tend to occur in pairs making chin enlargement a frequent tandem surgery with cosmetic rhinoplasty. Because an oversized nose makes a small chin appear smaller (and vice versa), correcting both features simultaneously has a dramatic and synergistic impact upon the cosmetic result.

Chin augmentation can be performed in a variety of ways, depending upon the underlying cause of the deficiency.

For patients with severe developmental bite relationships between the upper and lower jaws, known as malocclusion, a simple chin enlargement will not address dental misalignment issues or potential complications with premature wearing of the teeth and/or temperomandibular joint dysfunction (TMJ). In this case, orthognathic surgery is required to surgically reposition the upper and/or lower jaw bones to restore proper occlusion and bite relationships. Fortunately, these problems are rare and the complexities and risks of orthognathic surgery is seldom required.

For the remaining individuals with a small chin and normal bite relationships, less invasive but equally effective alternatives are available. In these patients, the teeth are straight (often as a result of orthodontics), but the chin bone, also called the mental process or the mentum, is too small, a condition known as microgenia. Patients with microgenia can have chins that are horizontally deficient, vertically deficient, or both. Fortunately, microgenia is not associated with functional abnormalities and represents only a cosmetic concern.

The cosmetic treatment of microgenia involves lengthening the chin, extending the chin forward, or both, depending upon the specific type of microgenia. Although pure horizontal microgenia is the most common, ranging in severity from mild to moderate, severe cases of microgenia usually involve both horizontal and vertical deficiencies. In contrast, severe vertical microgenia is seldom seen in isolation.

While some surgeons prefer to physically lengthen the jaw itself, an operation known as a sliding genioplasty, in my opinion this procedure is unnecessarily invasive and risky. Sliding genioplasty involves sawing off the mental process while avoiding injury to the sensory nerves and tooth roots, then advancing the chin bone forward and securing it in a cosmetically pleasing alignment using plates and screws. In addition to the risk of lip numbness and devitalized teeth, there is also a risk of bone resorption from a disrupted blood supply and/or infection of the plating hardware, particularly since the procedure is performed through a large intra-oral incision with contamination from saliva. Finally, the cosmetic impact of sliding genioplasty is often disappointing unless spacers or plates are used to fill the gap between the jaw and the chin fragment. Although it is often touted as an alternative to synthetic implants, sliding genioplasty is nearly always performed using synthetic or artificial materials.

A popular alternative to sliding genioplasty is augmentation genioplasty, which uses a synthetic chin implant to augment bone contour. Chin implants have been used successfully since the 1960’s and are now the most common treatment for microgenia. Early implants fashioned from solid silicone are now giving way to modern porous implant materials with improved safety and performance profiles. Materials such as porous polyethylene (Medpor), an inert plastic polymer, are engineered to be tissue-friendly with a very low risk of tissue rejection. Available in a wide variety of pre-formed shapes and sizes to accommodate virtually any specific type of microgenia, all Medpor implants are all manufactured with microporous channels to permit rapid and complete vascular ingrowth. Vascular ingrowth is a major advantage over non-porous implants such as silicone for two reasons. First, penetration of the entire implant by vascularized soft tissue promotes adherence of the implant to the underlying bone. Unlike non-porous implants such as silicone that encapsulate (or form a fibrous sac or capsule around the implant) and move freely with the soft tissues, porous implants adhere to the bone and feel like real bone both to the patient and to anyone who touches the jaw. The lack of mobility also prevents erosion of the underlying bone, a problem commonly seen in mobile implants. More importantly, vascular ingrowth also permits complete access of the implant to the immune system, thereby greatly reducing the long-term risk of implant infection. However, vascular ingrowth does not preclude safe removal of the implant should that become necessary.

Like all synthetic implant materials, porous chin implants should be exposed to a little contamination as possible. Although inserting the implant through the mouth conceals the incision, intra-oral insertion also bathes the implant in contaminated saliva. Because a small skin incision beneath the chin is unlikely to result in a visible scar, extra-oral insertion is recommended for chin implant placement. In addition to reduced contamination of the implant, extra-oral insertion also results in far less tissue disruption with a corresponding reduction in risk, pain, swelling, and recovery time. Typically, with the extra-oral approach, patients are chewing and speaking normally by the following day. Because chins are seldom perfectly symmetric, synthetic implants can also be modified in surgery to compensate for asymmetries. Medpor implants are firm yet malleable, and can be carved with a scalpel for a more precise custom fit. For all of these reasons, I use Medpor implants exclusively.*

* I have no financial interests in Porex (manufacturer of Medpor facial implants), and I am not a paid consultant for Porex. I received no compensation, monetary or otherwise, for the above unsolicited endorsement.

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Chin Augmentation Surgery – Augmentation Genioplasty …

Colorado Chin Augmentation (Genioplasty) for the Denver Area

Home | Facial Surgery | Chin Augmentation

We want you to love the way you look. Use our discreet online form to contact Dr. Andrew Wolfe, Dr. Steven Vath, and Dr. Paul Steinwald, board-certified Colorado plastic surgeons, about your chin augmentation.

Chin augmentation helps bring the profile of the face into balance. An implant is placed over the chin bone, which corrects the recession or “weak chin”. Often, a chin augmentation is considered when patients are contemplating a reduction rhinoplasty in the Denver area because it assists with bringing the chin into proportion with the nose and balancing overall facial aesthetics.

Visit our specialty site, Denver Mini Facelift, to learn about your full range of cosmetic options. Chin augmentation is just one of the Colorado facial rejuvenation procedures we perform.

The Center for Cosmetic Surgery has two offices conveniently located in the Denver metropolitan area. One is located just outside of Denver in lovely Golden, Colorado immediately off 6th Ave West and the other is located downtown in Cherry Creek, Denver. Please schedule a personal consultation to learn what a chin implant can do for you. Simply call (720) 279-1926 or request your complimentary consultation onlineyour complimentary consultation online.

For information about preparing for your surgery and post-operative guidelines, visit our Patient Resources page.

2015 The Center for Cosmetic Surgery. All rights reserved

725 Heritage Rd #100 Golden, CO 80401

Medical Web Site Design by Etna Interactive

Board certified plastic surgeons Dr. Steven Vath, Dr. Andrew Wolfe, and Dr. Paul Steinwald specialize in face lifts in Denver as well as breast enhancement, liposuction and tummy tucks. They serve all of Colorado including Golden, Aurora, Evergreen as well as Southeast Wyoming.

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Colorado Chin Augmentation (Genioplasty) for the Denver Area

Chin Reshaping (Genioplasty) | Caroline Mills Cosmetic …

People seek advice for surgery to their chin and jaws for many reasons and at all ages. You may feel that your chin and jaw is either too small or too big and wish surgery to improvement the appearance. Also if your chin or jaw is small then this may give unwanted prominence to the nose as well, and patients seeking nose surgery to reduce the size of the nose may not be aware that a small chin is just accentuating a slightly large nose. If this is the case then correction of the chin or jaw at the same time as nose surgery may help balance out your facial profile.

If you feel you have a problem with your chin or jaw then you need to be assessed regarding your chin, jaw and dental occlusion. Sometimes the actual jaws themselves maybe either too small or too large and the dental occlusion may need adjustment with braces and jaw surgery combined. This type of treatment is known as orthognathic surgery and involves input from both a Consultant Maxillofacial surgeon and a Consultant Orthodontist.

All patients considering chin and jaw surgery should be assessed with appropriate x-rays which look at the amount of bony movement required at surgery and also assess the jaw for any dental or bony pathology which may affect surgery.

If you have a large chin then surgery maybe undertaken in one of two ways to reduce the size.

If you have a small chin then there a number of options which can be considered in order to give your jaw and face a better appearance. If your chin and jaw is of a normal height and width then a chin implant may be suitable to improve the projection of the chin. Generally implants are suitable for smaller advancements and if larger movements or movements are needed to change the width or the height of the chin then a genioplasty should be considered.

Chin Implants

These have been made from a number of materials but the commonest ones on the market today are:

All of these implant materials have been shown to be safe materials for this type of surgery. Implants maybe placed from an incision made either inside the mouth or from an incision made under the chin. The implant is placed adjacent to the chin point and fixed into position with either sutures or small screws and the wound is closed using resorbable sutures in the mouth or non-resorbable sutures under the chin.

Limitations of chin implants mean that they can only provide an augmentation of the chin without changing the vertical height or the width of the chin. They are usually placed for smaller chin augmentations. They risk getting infected and if this occurs the implant may need removing. This then needs to be either replaced once the infection has settled or a genioplasty undertaken. Sometimes the implant can cause wear on the underlying bone and occasionally cause damage to the underlying dental roots. They also can sometimes move around after placement unless securely fixed with screws. Sometimes the edges of the implant can be palpable.

Genioplasty

Genioplasty is a procedure that is often perceived as more invasive than the use artificial chin implants as it means making a cut in the bone to move the chin. However, longer term the bones heal into the new position and the new chin is just a normal part of the bony skeletal framework of the face. Problems such as implant movements, infection, bony erosion and implant rejection do not occur. The bony fragments are fixed together during the healing process with small titanium plates and screws which usually remain in place. These can occasionally need removal if they get infected but this is a minor procedure and does not affect the position or appearance of the chin.

Another advantage of the genioplasty over a chin implant is that if the bony chin is advanced, the muscles that support the floor of the mouth and the upper part of the neck are also advanced as they attach to the posterior aspect of the chin. This will therefore improve the contour of the neckline at the same time.

The bony genioplasty also offers much greater versatility than an implant. As well as moving the chin forward or backward, you can also change the vertical height or the width of the chin by removing a small amount of the bone to reduce the height or the width, or by grafting to increase the height or the width of the chin. Grafting can be with either the patients own bone (preferred) or with a bone substitute which over a period of time (usually 12-18 months) will allow normal bone healing into the gap.

Chin surgery is usually carried out under general anaesthesia although sometimes can be performed under local anaesthetic with or without sedation if requested. Patients are usually discharged home following a one night stay in hospital although some patients having chin implants or a minimal chin reduction may go home the same day.

Some bruising and swelling will occur for the first few days and recovery to normal activity takes 7-14 days. The final shape of the new chin may not be fully appreciated until a number of months following surgery when all the swelling and tissue oedema has settled.

If an intra-oral approach is used then a soft diet is usually recommended for the first few days in order to allow the wound chance to heal. Antibiotics and mouthwash will usually be given and good oral hygiene is very important during this time.

Any sutures placed in the skin should be removed 6-7 days following surgery.

Complications of any surgery include the risk of bleeding, infection or damage to adjacent structures. In the case of chin surgery there are nerves that supply sensation (feeling) to the lower lip. These can be stretched and bruised causing the lip to feel numb or tingly. This is usually temporary although can take weeks to months to recover and in a small number of cases can persist permanently.The skin overlying the chin point can also feel numb following chin surgery, again this will usually recover with time.

The teeth can also be damaged in this type of surgery and this is why x-rays are undertake to assess the position and length of the teeth as well as to assess for any pre-exisitng dental or jaw problems.

Repeated chin surgery can weaken the muscle that helps support the chin tissues during talking and eating. If you require repeat chin surgery then occasionally we may recommend additional fixation of the soft tissues to try and prevent against problems with the soft tissues long term.

In summary there are a number of different types of chin surgery that can be undertaken and a full assessment both clinically and with radiographs is important to determine the best type of treatment.

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Chin Reshaping (Genioplasty) | Caroline Mills Cosmetic …

Can I Add Chin Implant on Top of my Sliding Genioplasty …

Can a chin implant be added after having a sliding genioplasty? If so, will additional screws be needed to secure the implant besides the screws in the bones? Will there be problems having so many screws in your body?

Additional screws may not be necessary if there is periosteum present or scar tissue to secure your chin implant.

Although the risks are higher, patients can have a chin implant after a sliding genioplasty. Make sure you see a qualified surgeon who has a lot of experience placing chin implants and working with the face.

Web reference: http://www.shahfacialplastics.com/chin%20augmentation.html

Adding dermafillers for some more augmentation is a great option after either chin implant or sliding genioplasty surgery. The chin projection may be enhanced without the risks of nerve or bone injury.

Radiesse works very well for chin augmentation. A longer lasting solution for non-surgical chin augmentation would be Artefill.

Good luck in your search for information.

Web reference: http://yourfaceinourhands.com/plastic-surgery/dermafillers.cfm

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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Can I Add Chin Implant on Top of my Sliding Genioplasty …

Chin implant – sliding genioplasty Belgium – Singelberg …

Genioplasty is a procedure used to improve the appearance of a persons chin. This can take the form of chin height reduction, rounding or augmentation using osteotomy (cutting the bone) or implants.

A sliding genioplasty, involves mobilizing a horseshoe-shaped piece of the bottom part of the chin bone by osteotomy and sliding it either backwards or forwards, finally fixing it in place with two or three little titanium screws. The teeth are not moved in this operation (that is called a sagittal osteotomy of the mandible), which we can do as well, but this is a procedure intended to realign the upper and lower teeth.

This procedure is performed through an intra-oral incision. The bony piece is cut and then moved forward and secured with screws. Placement of a bone graft is also an option, although we usually only do that for reconstructive cases. Do know that you will be able to feel some slight dents both underneath the jaw and in the front part of the new chin where it was slid forward. However, tissue will cover your new chin and look very natural. There are no visisble scars.

Genioplasty has more of an incidence of nerve damage (especially the inferior alveolar and mental/menton nerves) than chin augmentation via alloplastic implants. It is the most difficult or time-consuming for the surgeon to perform and has more down time, but less risks in the long run. The advancement can be very slight or more dramatic, depending upon your needs.

The results can appear very natural when performed correctly. The results may be comparable to a chin implant. The choice of an implant or bone advancement is up to the patient and neither one is risk free.

This is a picture of an osteotomy of the mandibula (lower jaw ) + a sliding genioplasty. The mandibula bone cut will realign the teeth, whereas the chin work only has a cosmetic effect. Both procedures may be combined or done separately.

An intraoral incision is placed within the lower portion of the inside of the mouth between the lower gums and the bottom lip/chin area. This is beginning to be the incision placement of choice for most surgeons. Although the intraoral incision has the advantages of no visible scar, it runs the risk of a slightly higher rate of infection due to the bacteria present in the mouth. Be sure to tell your doctor if you smoke or have any gum disease or cavities. These two factors could cause an infection as well as impede healing.

The second option is referred to as an extraoral incision or quite simply under the chin. We dont do this very often.

Conclusion: an implant is only good if it is for a small augmentation.

Aftercare in case of problems:if the implants slips, the only thing one can do is remove it . This means the pocket was made too big. There is no way one can fix a slipped silicone implant.

If it gets infected , the treatment is removal and a new implant after 4 months. Removal would be free (under a local anaesthetic) , but a new insertion would cost you 500 (under a twilight) .

Eat soft foods during the first 2 weeks, rinse your mouth after each meal and drink with water (no sugar) , and brush your teeth twice a day (gently) . Chorhexidine mouth-wash is useful after surgery.

No tonguing the incision or touching it with your fingers or any other object unless specifically told by your surgeon.

Sutures are dissolvable . If still not dissolved after 10 days, it is best to have them removed in the office or by your nurse/ GP.

Injectable products for chin augmentation can deliver immediate results but is only good for a minor chin augmentation (eg Radiesse).

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Chin implant – sliding genioplasty Belgium – Singelberg …