Esthetic Surgery of the Chin in Cis- and Transgender Patients—Application of T-Genioplasty vs. Single-Piece Segment Lateralization

Abstract

Background and Objectives: Correction of lower face asymmetry still remains challenging in maxillofacial surgery. This report describes techniques for the lateral transposition of the symphyseal segment to restore lower face symmetry while maintaining gender-related features in cis- and transgender patients. Materials and Methods: A retrospective review of medical records of 31 patients who attended for esthetic corrective surgery after orthodontic camouflage or orthognathic treatment, or during facial feminization of the lower face between June 2021 and June 2023 was performed. Result: All patients underwent lateralization genioplasty (with or without advancement or setback), either with or without narrowing T-osteotomy supplemented with necessary procedures in order to obtain proper facial balance and desired esthetical effects, such as bichectomy, liposuction, and face and neck lift. The mean asymmetry of the chin was 5.15 mm and was surgically corrected either by single segment lateralization or T-shape narrowing genioplasty depending on the gender and esthetical requirements. No complications were reported. Conclusions: Lateral shift genioplasty serves as a powerful tool in primary and secondary corrective surgery for lower face asymmetry that maintains gender-specific facial features. It may serve either as an additive to orthodontic camouflage or a way to correct previous orthognathic surgery pitfalls. The surgeon performing esthetic genioplasty associated with gender-specific expectations must be trained in facelift and facial liposculpting techniques in order to provide the best results and properly choose the right procedures for the right patients.

Major clinical approaches at the aesthetic level and complications of bichectomy: a systematic review

“…The number of people seeking to undergo the bichectomy (BC) procedure to acquire a younger-looking face, with a harmonious pattern, has increased significantly. However, there are few studies on tissue behavior with post-operative patient follow-up [1,2].…”

“…In this sense, in the literature, studies that describe the management of the Bichat's fat ball with the objective of facial harmonization are restricted to case reports or series of cases [1][2][3]. Although there are reports of late postoperative monitoring and evaluation, none of the studies statistically evaluate tissue behavior.…”

“…According to the Brazilian Society of Plastic Surgery in 2016, 7,362 people underwent bichectomy, which represents 0.5% of the total number of aesthetic surgeries [1]. To correct facial imbalances, bichectomy (BC) is one of the most sought-after solutions, consisting of a set of surgical techniques that aim at people's physical and psychological well-being, improving facial aesthetics, so that they can work together with other surgical practices, such as rhinoplasty, blepharoplasty and malarplasty to improve BC [2].…”

“…Its peculiar anatomy and the possibility of using this structure for aesthetic or reconstructive purposes have already been studied by several authors. Satisfactory aesthetic results can be obtained through the manipulation of buccal fat, either through its transposition as a graft or flap for filling or through its resection, the so-called bichectomy [1,12].…”