Aesthetic Genioplasty Based on Strategic Categorization

Abstract

Background: Genioplasty is a popular procedure used for lower facial contour correction. Various osteotomy techniques enable us to perform advancement, setback, reduction, or narrowing procedures. Computed tomographic images facilitate preoperative planning in detail. The authors used a novel planning method based on strategic categorization. The analytic results are described. Methods: This retrospective study reviewed 208 patients who underwent genioplasty procedures for facial contouring from October of 2015 to April of 2020. During preoperative evaluation of the mandible, the operative procedure selected was one of three types: (1) horizontal segment osteotomy, (2) vertical and horizontal segment osteotomy, and (3) bone graft after repositioning. Adequate osteotomies were followed by rigid fixation using a titanium plate and screws. The follow-up period ranged from 8 to 24 months (average, 17 months). The results were assessed based on medical records, photographs, and facial bone computed tomographic images. Results: Overall, the patients were satisfied with the outcomes and had responder-based improvement in lower facial contour and balance. Chin point deviations were noted in 176 cases; left-side deviation (n = 135) was more frequent than right-side deviation (n = 41). Strategic osteotomies based on precise measurements led to correction of asymmetries. Temporary partial sensory losses reported in 12 cases resolved within an average of 6 months after surgery. Conclusions: Each patient’s chief complaint and bony structures should be carefully evaluated before genioplasty procedures are performed. During the operation, meticulous osteotomy, precise movement, and rigid fixation are necessary. The strategic process used for genioplasty resulted in aesthetic balance and predictable outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.