Chin surgery is an essential part of orthognathic surgery, and should be considered in the treatment planning. If the answer is yes, then the right surgical strategy is the next step. The chin can be made wider or smaller and can be placed forwards or backwards. The chin can be set back, lengthened, or shortened. The chin can be spatially rotated or translated or shaved and remodelled.
The chin is of vital importance in overall facial aesthetics, as are the cheekbones. The position of the chin influences and directs the whole architecture of the face. The surgery can be done in a single session or as a complement during orthognathic procedures. The surgery takes 30-60 minutes.
The surgical access is an intra-oral incision behind the lower lip. This incision line is barely noticeable after one week and heals extremely well. The bone is cut in the appropriate zone, well underneath the exit of the sensibility nerve of the lip (mental nerve), and well underneath the root tips. This is done with a reciprocating saw. The chin point is relocated, whilst artificial bone grafts and a membrane can eventually be added when indicated. The chin bone is fixed with two titanium screws and/or a specific chin mini-plate. The muscles are reattached with resorbable PDS sutures and the overlaying tissues are closed. After surgery, a steri-strip dressing is applied to the chin for some days. This is to settle the chin muscles firmly to the bone. The surgery takes 45-60 minutes and is usually carried out with upper or lower jaw surgery or as a separate operation. The chin operation is always carried out under general anaesthesia.
Frequently asked questions
- Is a silicone implant or medpor implant an alternative method?
Some surgeons are indeed using silicone or medpor, and often the implant is inserted through a sub-mental skin incision. Maxillofacial surgeons usually do not use implants or a sub-mental skin incision. After being in place for years, silicone often gets pushed deep into the bone, sometimes ½ to 1cm. This is caused by the pressure of the muscles overlaying the implant, melting away the chin bone over time. Dr Defrancq has removed several of those and replaced them with a proper genioplasty advancement.
- Are nerve disturbances an issue?
There can be some temporary sensibility alterations to the lower lip, as there is with lower jaw surgery (BSSO). Normally, this fades away after some time.