Incorporating the Osseous Genioplasty Into Rejuvenation of the Lower Face

Abstract

Background The chin plays a critical role in the shape, projection, and soft tissue support of the lower face. Osseous genioplasty is a powerful tool in facial rejuvenation as it allows for optimal control of the resulting chin dimensions and improvement in submental and submandibular laxity. Osseous genioplasty can be used alone or in combination with other facial rejuvenation procedures to achieve an optimal result. Objectives We present the senior author’s approach to skeletal analysis of the lower facial third and propose an algorithm that can be used to optimize skeletal support of the overlying soft tissue laxity while maintaining aesthetic facial shape and proportion of the chin. Methods All patients undergoing cosmetic osseous genioplasty for soft tissue rejuvenation of the lower face and/or perioral region with the senior author between 2010-2021 were retrospectively reviewed. Complications including infection, numbness, prolonged ecchymosis were recorded. Results A total of 37 patients underwent cosmetic osseous genioplasty. The average age of the cohort was 44.5 years. Twenty-six patients (70.3%) were female. Eleven patients (29.7%) underwent genioplasty alone. In addition to genioplasty, eight patients (21.6%) underwent orthognathic surgery, five patients (13.5%) underwent platysmaplasty and liposuction, and two patients (5.4%) underwent facelift. The authors propose an algorithm to guide evaluation of the lower facial third to help determine the possible role of osseous genioplasty for facial rejuvenation based on each patient’s unique facial characteristics. Conclusions In properly selected patients, osseous genioplasty can improve lower facial projection, submandibular laxity, and perioral soft tissue support while also optimizing facial shape and proportion.

Trends in Craniofacial Fellowship Career Outcomes: A Call for Expanding Professional Opportunities in Craniofacial Surgery

“…Unlike chin implants, genioplasty stretches the muscles attached to the genial tubercle, allowing for 3D repositioning to achieve a wider range of soft tissue support. With a thorough understanding of the skin-to-bone interplay, the craniofacial surgeon can modify facial skeletons to optimize skeletal support of the overlying soft tissue, enhancing results in facial rejuvenation 22…”

“…With a thorough understanding of the skin-to-bone interplay, the craniofacial surgeon can modify facial skeletons to optimize skeletal support of the overlying soft tissue, enhancing results in facial rejuvenation. 22 Finally, traditional areas of adult craniofacial surgery exist, such as primary and secondary facial trauma reconstruction, cranioplasties, and rhinoplasty. Craniofacial surgeons are wellpoised to establish robust rhinoplasty practices, given the nature of the patients encountered: trauma, asymmetry, cleft, orthognathic, orthognathic camouflage, and GAS.…”

Optimizing Esthetic Outcomes and Bone Stability: Chin Advancement Through Inverted V Osteotomy

“…Consequently, there are difficulties in achieving optimal esthetic results for individuals with small chins using conventional genioplasty techniques. [1][2][3] One of the most commonly used methods for chin advancement is the horizontal sliding osteotomy of the mandibular symphysis. In this approach, a horizontal osteotomy is performed ∼5 to 6 mm below the mental foramen.…”

“…However, addressing chin recession is a challenging task, mainly due to the limited availability of bony substances for an osteotomy. Consequently, there are difficulties in achieving optimal esthetic results for individuals with small chins using conventional genioplasty techniques 1–3 …”