Chin Augmentation / Genioplasty

Background

Genioplasty is an operation to alter the shape of the chin. This can be to enhance a weak chin, to shorten a chin that is too high, or to correct deviation in a chin that is not centered. The most common reason is to enhance a weak chin. Many patients with this concern also have a prominent mid-face and nose, and consequently this procedure is often done at the same time as a Rhinoplasty (Nasal Surgery). This surgery does not require a plastic or silicone implant, which are prone to infection and shifting, but rather uses the patients’ bone to reshape the chin. In order to plan this surgery accurately, Dr. Goldberg will order special dental X-rays called cephalograms.

The Procedure

Genioplasty is done under general anesthetic as a day-surgery procedure. It usually takes about 1.5 hours, but would be longer if combined with another operation. You are typically allowed to go home within 2 hours after surgery is finished. During the operation Dr. Goldberg injects long acting local anesthetic to prevent sensitization of the pain nerves at the time of the procedure and significantly prevent discomfort after surgery. The incision is made next to your gumline on the inside of your mouth. The bone of your chin is then cut to allow the needed movement and adjustment as planned between you and Dr. Goldberg. The segment of bone is below the level of your teeth, and your teeth are not affected by this operation. The bone is then fixed into its new position with a few small titanium screws, which cannot be seen or felt from the outside. These remain permanently. The incision is then closed with dissolvable sutures.

Recovery

Dr. Goldberg prescribes several medications to ensure your comfort. These usually include Celecoxib and Percocet to control inflammation and painand an antibiotic to help prevent infection. Swelling and discomfort usually maximize after 3 days, and then subside quickly. It is best to take 1 week off of work if you are able to. You should avoid strenuous activity, such as heavy lifting, work-outs, or running for 4 weeks after surgery. You need to avoid contact sports (including martial arts) for 6 weeks. Following this you may return to normal activity.

Risks

There are general risks with Genioplasty such as bruising, bleeding, infection, and risks associated with general anesthetic. There are also some specific risks. The nerves that give sensation to your lower lip chin, and teeth may be temporarily, or very rarely permanently, injured. Infection of the bone rarely occurs and may require removal of the titanium screws. Another rare complication is movement of the bone due to loosening of the screws. If this happens it may require more surgery to fix. It is possible that a screw may injure a tooth, and may require dental restoration. Dr. Goldberg takes great care to avoid such an injury.

Alternatives

Sometimes movement of the chin is not adequate, and movement of the entire lower and/or upper jaw is required. This is known as Mandibular and LeForte I osteotomies. The decision about which operation is best for you requires careful examination of your bone and teeth as well as special dental X-rays. Instead of Genioplasty you may instead have a plastic or silicone implant inserted. For very minor deformity it is possible to camouflage it with Filler Product such as Perlane or Juvederm Ultra..

Benefits

This operation can significantly improve the balance and symmetry of your face. It is a natural, effective and long lasting solution that uses your own tissue rather than implants. It requires minimal down-time, and is done purely through incisions inside your mouth, thus leaving no external scars.