Genioplasty: Why operate?

The chin osteotomy (called “mentoplasty or genioplasty”) aims to reposition the chin when it is too forward, too backward, too high or not high enough and/or asymmetrical.

Live Discussion on Genioplasty | Chin Surgery | Dr. Shilpi Bhadani – 2022

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Why operate?

The chin osteotomy (called “mentoplasty or genioplasty”) aims to reposition the chin when it is too forward, too backward, too high or not high enough and/or asymmetrical.

Chin osteotomy is sometimes combined with jaw surgery (maxillary and/or mandibular osteotomy) or rhinoplasty as part of profiloplasty.

How is the intervention carried out?

The operation is performed under general anesthesia after a pre-anesthesia consultation.

In most cases, the chin is approached by incisions of the oral mucosa (no external scar). The surgeon cuts the chin below the teeth, which allows it to be moved in the direction planned before the operation. The bone fragments are then fixed by steel wires or titanium mini-plates (osteosynthesis). Stitches are placed in the mouth. They disappear in 2 to 4 weeks or are removed in consultation.

Bone consolidation is obtained in almost a month and a half. Depending on the case, the osteosynthesis material can be removed remotely.

Usual post-operative follow-up and post-operative care.

• Bleeding from the mouth, frequent just after the procedure, is usually not serious.
• Swelling of the cheeks, lips and neck (oedema) is very common and sometimes severe. The mobility and sensitivity of the lower lips are sometimes reduced.
• Excellent oral hygiene is essential. Mouthwashes will be prescribed. After each meal, the teeth and gums should be cleaned with an ultra-soft brush. A water flosser can also be used.
• The pain is moderate, yields with analgesics and disappears in a few days. Ice packs wrapped in a cloth (not directly on the skin) reduce swelling and pain.

The precautions to be observed

• Smoking must be stopped 8 days before and after the intervention until the end of healing.
• Sports: not before 3 weeks for activities without any traumatic risk, not before 2 months for usual activities and not before 3 months for combat sports.

The risks

Any medical procedure, even well conducted, carries a risk of complications. Do not hesitate to contact the surgical team that treated you.

• Abundant bleeding is rare during the operation and may exceptionally require a blood transfusion, or even an additional surgical procedure.
• Sensitivity disorders of the lower lip, gums or teeth are common. They will gradually fade but the recovery can be long.
• An infection of the soft tissues of the chin or neck (cellulitis) may occur a few days to a few weeks after the operation and require appropriate treatment.
• A delay or absence of bone consolidation, often favored by external factors (trauma, etc.), is very rare and requires a new operation.
• Unexpected fracture lines during bone sectioning that may lead to lower jaw surgery.
• Consolidation in bad position. If the displacements are significant, another operation may be necessary.

In total, what to remember about genioplasty:

• Preparation: Shower with local Antiseptics.
• Duration of surgery: 45 to 90 minutes.
• Anesthesia: General anesthesia.
• Pain: Requires the use of analgesics.
• Care: Dressing and post-operative drain.
• Complications: Redness, bruising, oedema; rare: infection, malunion, sensory deficit.
• Temporary or permanent contraindications: treatment causing bleeding.
• Follow-up: Visit at 8-10 days, then at 6 weeks of bone healing; follow-up at 6 months.
• Social eviction: 3 to 10 days.

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