Genioplasty methods for correcting the lower third of the face

Abstract

Study Objectives. We represent our 6 years experience in remodeling the lower third of the face using different genioplasty techniques. Methods. We use standard and practically advisable methods for the lower face autologous contouring and alloplastic chin augmentation. Systemic preoperative assessment of the face symmetry and proportions is performed to reconcile patient’ expectations and surgical prognosis. Antibiotics are administered before the operation. We prefer mostly general anesthesia for genioplasties and combinational procedures. After operation light compressive dressing is applied with intermittent cooling. The final aesthetic result is visible after 12 months, but the shape changes are visible immediately after surgery. Results. During 2006–2012 period 40 patients underwent surgery of the lower third of the face (12 males and 28 females). 32 alloplastic chin augmentations and 8 genioplasties were performed. We use mostly high density polyethylene ‘Porex’ implants for augmentation purpose. For 22 patients submental approach was performed and 12 patients respectively were operated intraorally. All chin implants were slightly modified to get proper shape and congruence and fixed with screws. 25 patients with chin malformations underwent simultaneously another surgery: nose deformity correction – 10 patients, face lift – 10 patients, endoscopic eyebrow lift – 3 patients, isolated neck correction – 2 patients. We got transitory lower lip paresis in 5 cases (for 4 patients intraoral incision and subperiosteal dissection was performed) and 2 chin implant infections (intraoral incision and subperiosteal dissection) with implant elimination after 3 weeks. Conclusions. More complications in chin remodeling surgery associate with intraoral approach and subperiosteal dissection. Genioplasty is a useful armamentarium in remodeling the lower third of the face.