Genioplasty and Its Types

Introduction

The chin has an important role in facial aesthetics and facial harmony. Chin surgeries are majorly performed for aesthetic reasons, but the functional impact, such as a receding chin causing breathing issues while sleeping, cannot be underestimated. Several techniques are there to enhance chin appearance, but genioplasty is considered the gold standard. An intraoral approach to performing chin surgery was first described by Trauner and Obwegeser. Several methods and adjustments have been described with the aim of reducing complications and recovery time, improving esthetical outcomes, and simplifying surgical procedures. The aim of minimally invasive genioplasty was to reduce postoperative dysfunction and recovery time.

What Is Genioplasty?

Genioplasty or chin surgery is a surgical procedure done to alter or reconstruct the chin. It is commonly called chin augmentation. The surgery is usually done to enhance the facial appearance, but it is also done if the person is having problems in his upper airways. It is a commonly performed plastic surgery procedure. It is performed by highly trained oral maxillofacial surgeons. Plastic surgeons with the necessary training and experience can also perform the surgery. The exact surgical procedure and recovery time differs depending on the type of genioplasty an individual will have and the extent of corrections to be performed.

Why Is Genioplasty Needed?

Generally, people undergo genioplasty to alter the physical appearance of the chin. Hence it is a form of cosmetic surgery. It is performed to correct problems such as:

• Overly extended or large chins.

• Receding chins or retrogenia.

• Asymmetrical or misaligned chins.

• Too short or too tall chins.

• Abnormal dental bite.

• Obstructive sleep apnea (a sleep disorder in which breathing constantly stops and starts while sleeping throughout the night).

What Are the Types of Genioplasty?

Genioplasty has two main types.

1. Sliding Genioplasty - In this type of genioplasty, the surgeon cuts the chin bone, separating it from the rest of the jaw. Then the chin is repositioned by sliding it forward or backward to correct the protruding or receding chins. Asymmetrical chins can also be corrected by reshaping or sliding one side of the chin to complement the other. Subsequent to repositioning the chin bone, the surgeon attaches it to the jaw with surgical screws.

2. Implant Augmentation - In this type of genioplasty, the surgeon uses plastic or silicone implants to reshape, elongate or enhance the chin. The surgeon places the implant over the chin bone and secures it with screws or stitches. A temporary nonsurgical alternative to chin implants is dermal filler injections. This involves injecting fillers to enhance the chin’s shape and overall appearance of the face. Fillers are fats, polycaprolactone, or calcium hydroxylapatite.

How Is Genioplasty Performed?

People should consult a licensed surgeon who will perform a clinical evaluation before the chin augmentation procedure. During the consultation, the surgeon will check the person’s current health status and medical history. The person will be asked to describe what he expects to achieve from the procedure. The surgeon will take a computed tomography (CT) scan and X-ray images of the jaw and measure the face. After that, the surgeon will decide on the most suitable type of genioplasty and start planning the procedure.

For sliding genioplasty, where and at what angle the chin bone will be cut is decided before the procedure. The personnel and equipment requirements are also decided. For implant augmentation procedures, whether to use implants or fillers, or a combination of both, is decided before the procedure. The material of the implant and fillers are also discussed and decided.

The surgical procedure requires general anesthesia. Generally, people are allowed to go home after their surgery; however, they should make transportation arrangements beforehand. People undergoing surgery should avoid eating solid food for six to eight hours before the surgery, and they can drink clear liquids until two hours before surgery.

• Sliding Genioplasty Procedure - The surgeon cut along the border of the inside of the lower lip and lower gums. A cut or incision is in the soft tissue layer to access the chin bone. After the chin bone is exposed, the surgeon makes small vertical cuts on the bone as reference points. Then a horizontal cut is made below the roots of the lower teeth. The height of the chin is adjusted by cutting it at different angles. To reduce the size of the chin or move it backward, a wedge-shaped piece of bone can be cut out. The bone fragment is then slid forward, backward, or sideways to check alignment and file excess bone along the jawline. After proper positioning of the bone, it is reattached to the jaw with screws and a metal plate. The surgeon closes the incision using the sutures, and compression plates are placed to minimize the swelling.

• Implant Augmentation Procedure - This procedure takes approximately an hour to complete the surgery. The surgeon makes a small cut under the chin or on either side of the mouth. Then the implant is inserted through the cut, positioned around the chin bone, and attached. The cut or incision is then closed using the sutures. In people undergoing nonsurgical augmentation, dermal fillers are injected around the chin, either side of the mouth or jaw. They may be required to repeat the procedure as the filler material tends to dissolve after many months.

How Long Does It Take To Recover From Chin Surgery?

The recovery time depends on the type of procedure, the extent of changes done during surgery, the ability of the body to heal, and complications. People with implant augmentation surgery can go back to work after seven days. The chin appears to heal completely in a few weeks. However, complete recovery may take up to three months. People with sliding genioplasty will have to go for regular follow-ups to monitor the healing and manage any complications. Dermal fillers have a shorter recovery time than the other two types of genioplasty and leave no scarring.

What Are the Risks and Complications of Genioplasty?

Genioplasty is a safe and effective method for enhancing the shape of the chin. However, surgical procedures do have some side effects and complications. The temporary side effects of genioplasty include:

• Bruising or redness.

• Swelling.

• Numbness or loss of sensation.

• Pain or tenderness.

The possible complications of the procedure include:

• Damage to tooth roots or nerves.

• Infection.

• Bleeding.

• Changes in implant position.

• Allergic reactions to implant material or fillers.

• Mandibular fracture.

• Disappointment with the results.

Conclusion

Genioplasty offers significant benefits for individuals dissatisfied with their chins. The size and location of the chin are integral for balancing facial features and contributing to facial harmony. It is generally a safe procedure with some temporary side effects. Genioplasty is a useful and frequently employed technique in the aesthetic facial field.