Genioplasty Research Articles

Effectiveness and Safety of a Hyaluronic Acid Filler for Chin Augmentation and Correction of Chin Retrusion: A Multi-center, Prospective, Randomized Controlled Trial.

The chin significantly influences facial aesthetics, contributing to the overall balance and harmony of the face. This study aimed to assess the effectiveness of the hyaluronic acid filler Hyamax® Volumizer for chin augmentation and correction of chin retrusion compared to a no-treatment control. Participants aged 18-55 years with mild to moderate chin retrusion were randomized in a 3:1 ratio to receive either the treatment group (n = 150) or control group (n = 50). Evaluations included blinded assessments using the validated Galderma Chin Retrusion Scale, Global Aesthetic Improvement Scale for aesthetic enhancement, and safety follow-up. The Galderma Chin Retrusion Scale responder rate (≥1 grade improvement) was significantly higher for the treatment group (70%) compared to the control group (0%) at 6 months (p < 0.0001), and remained higher at 12 months (54.67% vs. 0%; p < 0.0001). Aesthetic improvement rates were consistently high as reported by both blinded evaluating investigator (≥89.33%) and subjects (≥91.33%). Treatment-related adverse events were mild to moderate. Hyamax® Volumizer treatment is safe and effective when injected in the chin to treat chin retrusion, with results lasting through 1 year. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A case of bone resorption in the mentum caused by hyaluronic acid filler in a patient with skeletal Class II jaw deformity.

Chin augmentation by hyaluronic acid filler injection rarely causes abnormal bone resorption in the mentum. Thus, when taking the history of a patient with jaw deformity, it is imperative to check the history of treatment of the mentum. Hyaluronic acid (HA) filler injection is a common procedure in nonsurgical cosmetic chin augmentation. Due to its high biocompatibility and simple injection technique, HA filler injection is a popular procedure. However, adverse events such as allergic reactions and foreign body reactions have been reported in some cases. In this study, we report a case of skeletal Class II jaw deformity in which bone resorption was observed in the mentum after HA filler injection. The purpose of this study is to discuss the indications for HA filler injection in skeletal Class II cases that require orthognathic surgery. The patient was a 30-year-old woman. To improve retrusion of the mentum, she has been receiving HA filler injections in the mentum three times every 6 months in the cosmetic surgery clinic since 2015. However, the retrusion of the mentum did not improve, which prompted here to visit the orthodontic clinic. Radiographs and CT revealed bowl-shaped bone resorption surrounding the foreign bodies in the mentum. She was diagnosed with maxillary protrusion, vertical maxillary excess, mandibular retrusion, and bilateral condylar resorption. Bimaxillary orthognathic surgery (BOGS) and removal of residual HA fillers were planned after completion of the preoperative orthodontic treatment. After BOGS, the foreign bodies were completely removed, and the resorption cavities were filled with excess bone segments from the surgical sites. X-ray photoelectron spectroscopy analysis of the foreign bodies suggested the presence of HA. One year after the BOGS, no progression of condylar resorption occurred, and bone healing at the mentum had a good prognosis. Therefore, the patient underwent reduction and advancement genioplasty. She was satisfied with her facial profile and occlusal function. Unexpected bone resorption in the mentum caused by HA filler injection is often discovered incidentally. Although, patients may feel hesitant to confess their history of treatment of the mentum, it is important to ensure that they are carefully interviewed.

Mentum, Mouth Floor, and Tongue Necrosis Following Hyaluronic Acid Injection for Chin Augmentation.

Hyaluronic acid injection for chin augmentation presents a minimally invasive technique that has garnered increasing popularity. Although the chin region is generally regarded as relatively safe with a lower likelihood of ischemic complications, it is imperative to recognize that severe adverse events can still arise due to variations in vascular or bone structures. This article documents a rare case of necrosis affecting the chin skin, floor of the mouth, and tongue after hyaluronic acid injection for chin augmentation, which was successfully managed with reconstituted hyaluronidase injection.

Short-Term Outcomes of High-Density Porous Polyethylene Orthoses for Chin and Gonial Angle Augmentation.

This retrospective observational study evaluated 100 patients over 18years. Data on age, sex, aesthetic complaints, surgery types, and postoperative complications were collected and analyzed using the two-proportion z-test and descriptive statistics in RStudio 4.3.3. All patients with neuropraxia underwent neurosensory evaluation. The average age was 35.92years for males and 33.71years for females, with a male predominance (76%). Aesthetic complaints were prevalent in 72% of patients (p < 0.01). Chin surgery was performed on 56% of patients, jaw angle surgery on 17%, and both on 39%. Complications included one case of suture dehiscence, three wound infections, and four transient cases of paresthesia, all resolving within 30days. Overall, patient satisfaction with outcomes was high. High-density porous polyethylene implants proved effective and safe in enhancing facial aesthetics and correcting mandibular deformities. Further research should focus on long-term outcomes to consolidate these findings. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Factors Influencing Bone Resorption after Augmentation Mentoplasty with Implants: A Retrospective Study Using Three-Dimensional Imaging.

Augmentation mentoplasty with implants is an extremely rewarding procedure. Bone resorption is almost unavoidable. The high-risk factors for chin bone resorption have not been explored in the past. This study aimed to analyze and evaluate the factors influencing bone resorption after augmentation mentoplasty with implants using three-dimensional imaging. We retrospectively analyzed preoperative craniofacial Computed Tomography scan data from 105 patients who underwent mandibular implantation surgery and 108 patients who did not. We also examined the extent to which different factors influenced the occurrence of bone resorption in the chin area. Patients with silicone gel implants are more prone to bone resorption than those with Medpor implants. Patients who experienced bone resorption had thicker mentalis muscles than those who did not experience bone resorption (6.35 ± 1.mm vs. 5.73 ± 1.25mm, P < 0.05), and thinner cortical bone (3.25 ± 1.65mm vs. 5.22 ± 2.04 mm, P < 0.05). Additionally, implants placed above the mandibular bone were more likely to induce bone resorption than those placed below it. This study is the first to systematically reveal the impact of implant type, placement position, mentalis muscle thickness, and cortical bone thickness on bone resorption after chin augmentation surgery. For patients with thicker mentalis muscles and thinner cortical bones, greater attention should be paid to the occurrence of bone resorption. Choosing silicone implants or placing the implants higher on the mandible can help reduce the occurrence of bone resorption. This study can assist clinicians in selecting appropriate treatment methods, thereby reducing post-implantation bone resorption. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Chin and jawline augmentation: a frontier of aesthetic medicine

The heightened public interest in and usage of non-invasive cosmetic procedures has translated to the practice of jawline and chin augmentation. Implants have historically been a cornerstone of chin augmentation; however, more recently, as non-invasive procedural techniques and modalities develop, questions have been raised as to whether there is still a need for implants. Francesca Ramadan explores the innovative options available to address even the most acute patient concerns.

Hybrid Chin Advancement: Combining Fat and Sliced Cartilage Grafts for Chin Augmentation During Rhinoplasty

BackgroundFacial balance significantly impacts aesthetics, particularly in the middle and lower thirds. Patients with chin retrusion often benefit from sagittal plane chin advancement in rhinoplasty, enhancing surgical outcomes and satisfaction.ObjectivesThis article presents a method for analyzing chin deformities and discusses a hybrid treatment approach to harmonize facial features, complementing rhinoplasty.MethodsThe chin positions of patients treated by the senior author were assessed. A retrospective analysis included 49 patients with chin retrusion of 2.5–6 mm. Among them, 22 patients initially offered chin implants declined, leading to planned chin augmentation. Fat grafting was exclusively performed for 20 patients lacking sufficient cartilage. The "Hybrid Chin Advancement" technique involved supporting tissues beneath muscles with nasal septum cartilage and fat injections and tissues above muscles with fat injection alone.ResultsPre- and postoperative Legan angle measurements and chin advancements were compared across three groups. While preoperative Legan angles were statistically similar, postoperative Legan angles and advancement changes were significantly higher in the implant group (p < 0.0001). Comparing hybrid chin advancement and fat grafting groups, postoperative Legan angles and advancement changes were significantly higher in the hybrid chin group (p < 0.0001).ConclusionsFat grafting suffices for mild advancements (~ 2 mm), while the hybrid chin method is effective for moderate advancements (~ 4 mm). For advancements exceeding 6 mm, implants or osseous genioplasty are optimal. Our study’s hybrid approach offers an easy, safe, and reliable method for achieving facial harmony in the lower two-thirds without compromising patient expectations.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Comparison of the Impact of Chin Augmentation Treatments by Genioplasty versus Hyaluronic Acid Filler Injection on Facial Attractiveness of Patients with Mild to Moderate Microgenia

Comparison of the Impact of Chin Augmentation Treatments by Genioplasty versus Hyaluronic Acid Filler Injection on Facial Attractiveness of Patients with Mild to Moderate Microgenia

Understanding Public Awareness and Practices of Nonsurgical Facial Dermal Fillers: A Cross-Sectional Study in Saudi Arabia.

Dermal fillers augment soft tissues by replacing lost volume in the skin or subcutaneous fat. Dentists and other professionals utilize or recommend facial fillers for cosmetic and therapeutic purposes. This study aims to investigate public awareness regarding using nonsurgical facial dermal fillers in Saudi Arabia. A cross-sectional study was conducted using an online self-administered questionnaire distributed to a total of 400 males and females through social media platforms. The participants reside in Mecca, Saudi Arabia. Descriptive statistics and the Chi-square test were employed for data analysis. A total of 256 participants completed the survey, including 204 females and 51 males, with a mean age of 33.86 (SD = 10.5) years. Among the participants, 88 (34.4%) reported using facial fillers. Among them, only 46 (18%) were frequent consumers. Knowledge regarding correctly using facial fillers was generally high, especially for the lips (240, 94%), chin augmentation (203, 79.3%), and face lifting (226, 88.3%). However, participants' knowledge needed improvement in other areas. Most participants were aware of the side effects, except for visual impairment (83, 32.4%) and blockage of the vessels (128, 50%). The findings highlighted a remarkable level of knowledge among participants regarding the uses of fillers. However, participants demonstrated low awareness of all possible side effects associated with the treatment. Participants had valid reasons for undergoing facial treatments. However, constraints preventing them from pursuing fillers included fear of unexpected results and financial limitations.

EVALUATION OF THE EFFECTIVENESS OF GENIOPLASTY USING BIOPOLYETHYLENE (Su-por) IMPLANTS

Background: The chin an important aesthetic unit of the facial structure and play a key role in the appearance of the face. This study evaluated the surgical results of genioplasty using a Biopolyethylene implant (Su-Por). Material and Methods: The study included 42 patients with a follow-up period of 3 years who underwent genioplasty in the clinic from 2020-2023. All patients underwent a standard clinical examination and computed tomography (CT). To plan the required volume of chin augmentation, cephalometric analysis is used. The genioplasty surgery was planned on a 3D model of the skull, installing standard bioimplants on the 3D model of the obtained 3D printed CT image. Genioplasty was performed using a Biopolyethylene implant (Su-Por). Outcomes were assessed using the Outcome Assessment, consisting of a 10-item questionnaire completed preoperatively, 6 months postoperatively, 1 and 3 years postoperatively. Result: Among the 42 operated patients, no complications were observed during the operation. Complications were noted in the long-term postoperative period: swelling in 4 patients, in 2 patients with unsatisfied aesthetic results without other serious complications. In all clinical observations, stable support of the Biopolyethylene implants. The mean score was 26.4 at preoperative assessment, 78.2 at 6 months postoperatively, and 87.6 at 3 years postoperatively. The surgical results showed favorable aesthetic results, low infection rates, strong implant fixation, good skin texture/skin/soft tissue thickness. This technique is simple and effective and is recommended for inclusion in the practice of a facial plastic surgeon. Conclusions: Augmentation genioplasty using the Biopolyethylene implant is a simple and effective surgical procedure that can lead to aesthetically acceptable results with minimal pain using. Patients are satisfied with the aesthetic and functional results genioplasty.

Custom-Made Implant Fabrication for Chin Augmentation Using Piled-Up Expanded Polytetrafluoroethylene Sheets: An Innovative Surgical Technique and Literature Review

BackgroundAlloplastic chin augmentation is the most common esthetic surgical treatment to reshape the chin. However, factory-made chin implants are typically standardized rather than custom-made and have potential to cause complications. Although the fabrication of custom-made implants by using computer-assisted planning and 3D-printing technology has become widespread, the process has several disadvantages, including long preoperative prosthesis preparation times, high costs, and unsuitability for patients with asymmetric chins or those who undergo combined mandibuloplasty before implant placement. The present study developed an innovative chin augmentation technique involving stacked expanded polytetrafluoroethylene (e-PTFE) sheets that is suitable for most patients and has minimal side effects.Materials and MethodsA retrospective review of a single surgeon’s experience was performed over a 2 year period for patients who underwent a procedure involving piled-up e-PTFE sheets for alloplastic chin augmentation. This study analyzed the outcomes, complications (temporary nerve numbness, wound infection, hematoma formation, and implant displacement), and patient satisfaction during follow-up.ResultsBetween January 2018 and December 2020, 38 patients underwent the procedure involving piled-up e-PTFE sheets for alloplastic chin augmentation. Six patients (15.8%) experienced nerve-related temporary numbness, and one (2.6%) experienced wound infection. None had developed major complications such as implant displacement or wound infection at follow-up. Moreover, the patients demonstrated a high level of satisfaction with the surgical results.ConclusionPiled-up e-PTFE sheets can be used to produce custom-fit porous polyethylene chin implants that result in minimal complications and a very high satisfaction rate.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Chin Augmentation and Treatment of Chin Retrusion with a Flexible Hyaluronic Acid Filler in Asian Subjects: A Randomized, Controlled, Evaluator-Blinded Study

BackgroundAesthetic improvement of the chin is increasingly requested by patients, including those of Chinese origin.MethodsA randomized, evaluator-blinded, no-treatment controlled study evaluated the effectiveness and safety of a flexible hyaluronic acid (HA) filler, Restylane® DefyneTM (HADEF), in the correction of chin retrusion in a Chinese adult population over 12 months after treatment. On Day 1, subjects were randomized 3:1 into two groups, HADEF or delayed-treatment controls, and those in the HADEF group were administered treatment. An optional touch-up treatment was administered 1 month after treatment to obtain optimal chin augmentation. The initially untreated control group was offered delayed-treatment after 6 months (including 1-month touch-up).ResultsHADEF was superior to no-treatment in improving chin retrusion according to the blinded evaluator at 6 months [Galderma Chin Retrusion Scale (GCRS) responder rate (≥ 1-point improvement from baseline) of 81% vs. 5% for untreated controls; p < 0.001, meeting the primary effectiveness objective. A majority of subjects maintained improvement at 12 months (61% in the HADEF group). All subjects reported satisfaction with results at 6 months after treatment with HADEF and aesthetic improvement rates per the global aesthetic improvement scale (GAIS) were high for 12 months following treatment, with an acceptable safety profile.ConclusionsThese results demonstrated HADEF to be effective and safe for the correction of mild-to-moderate chin retrusion in Chinese subjects, confirming findings previously observed in a western population.Level of Evidence I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Imaging characteristics of incidentally detected cosmetic surgery-derived foreign bodies on CT images in the maxillofacial region

ObjectivesThis study examined the imaging characteristics of cosmetic surgery-derived foreign bodies in the maxillofacial region through a retrospective review of cosmetic material foreign bodies incidentally detected on computed tomography (CT) images in routine clinical practice.MethodsWe retrospectively investigated cases of cosmetic surgery-derived foreign bodies other than dental materials in the maxillofacial region, using 5 years of CT image data stored on an imaging server. The imaging findings of these foreign bodies were investigated, along with patient age, patient sex, whether the foreign bodies were associated with the disease targeted by the CT scan, and the availability of cosmetic surgery information prior to examination.ResultsForeign bodies were more common in women (19/21 cases), and affected patients displayed a wide age range (20–84 years). Four types of cosmetic surgery-derived foreign bodies in the maxillofacial region were detected by CT examination: nasal prostheses (nasal region), lifting sutures and injectable facial fillers (both in the buccal region), and silicone chin implants (chin region).ConclusionsA cosmetic surgery-derived foreign body should be suspected when a foreign body is identified without a dental source of infection. In addition, cosmetic surgery-derived foreign bodies may be present in numerous patients, regardless of age or sex.

Treatment of Chin Retrusion With Botulinum Toxin Plus Hyaluronic Acid Filler in Comparison With Hyaluronic Acid Filler Alone: A Randomized, Evaluator-Blinded, Controlled Study.

Hyaluronic acid (HA) has already been widely administered for chin augmentation. Patients with chin retrusion frequently present with increased chin hypertonia. Monotherapy with HA falls short in addressing the multifaceted cosmetic concerns associated with chin retrusion. This study aimed to investigate the clinical efficacy and safety of the combination therapy involving botulinum toxin (BTX) and HA in the treatment of chin retrusion. We enrolled patients with moderate to severe chin retrusion for 9 months of follow-up after they received either combined treatment with BTX plus HA or monotreatment with HA. We also calculated the surface-volume coefficient with 3-dimensional digital scanning technique, and evaluated outcomes based on the Allergan Chin Retrusion Scale (ACRS), the Global Aesthetic Improvement Scale (GAIS), and treatment-related adverse events (TRAEs). A total of 50 patients were recruited and randomized to the treatment group (BTX plus HA) or control group (HA alone) in a 1:1 ratio. Patients in the treatment group exhibited significantly higher surface-volume coefficients during the first 6 months (P < .05). ACRS scores and responder rates in the 2 groups remained similar throughout the follow-up (P > .05). Within the initial 3 months, the GAIS responder rate in the treatment group was significantly higher than that in the control group (P < .05). Mild TRAEs were observed in both groups, and subsided within 7 days. There was no increase in adverse effects with the combined treatment. In comparison to monotherapy, the combined treatment not only improved the surface-volume coefficient of hyaluronic acid but also achieved similar ACRS scores with less HA volume. Furthermore, the combination treatment yielded superior treatment outcomes for individuals with chin retrusion.

A Novel Chin-Reductive Drawer Genioplasty Using Subapical and Mandibular Contouring Ostectomy.

As the most prominent feature of the lower face, the chin is crucial to human facial morphology, and plays a large role in contributing to facial attractiveness and harmony. Although an increasing number of genioplasty procedures are being introduced for chin augmentation, chin reduction procedures are rarely performed. Because of the inevitable cervicomental angle widening and relaxation of the floor-of-mouth muscles caused by chin shortening and the elevation of the lower edge of the mandible, chin reduction remains a challenging procedure. The authors' novel drawer-genioplasty approach involves a flexible chin-reducing procedure using subapical and mandibular contouring ostectomy. This technique can effectively shorten various types of long chin for improved facial proportions and maximize floor-of-mouth muscle protection during surgery, thereby avoiding postoperative submental sagging. Several measures, including the ratio between the lower (subnasale to menton distance) and middle facial heights (glabella to subnasale distance) (R1), the ratio between the anterior midline bone heights of the mandible (stomion to menton distance) and maxilla (subnasale to stomion distance) (R2), and the cervicomental angle, were used to evaluate the outcome of the procedure. Comparing the preoperative and postoperative measures revealed that there was a significant decrease in both R1 (1.25 ± 0.15 versus 1.09 ± 0.12) and R2 (1.94 ± 0.24 versus 1.58 ± 0.11). Although cervicomental angle increased from 107.3 ± 8.2 degrees preoperatively to 112.4 ± 7.0 degrees postoperatively, this value was still within the normal range. In addition to providing effective and significant aesthetic improvements, drawer genioplasty is safe and involves no complications. Therapeutic, IV.

The versatility of Bio-Oss® Collagen in orthognathic surgery: two case reports from vertical chin augmentation to pseudoarthrosis treatment

The versatility of Bio-Oss® Collagen in orthognathic surgery: two case reports from vertical chin augmentation to pseudoarthrosis treatment

Transoral endoscopic thyroid surgery via vestibular approach with silastic chin augmentation genioplasty.

From July 2020 to March 2022, 3 patients with papillary thyroid cancer (PTC) and microgenia underwent transoral endoscopic thyroid surgery via a vestibular approach or a endoscopic lateral neck dissection via the breast and transoral approaches with chin silastic augmentation genioplasty performed concurrently. Image documentation, patient satisfaction, complications and other factors such as demographics and clinicopathologic details were recorded. None of the patients developed major complications and there were no complications such as infection or displacement of the implant. All patients were satisfied with the cosmetic outcomes. Despite the study being limited to these 3 selected patients with PTC and microgenia, the follow-up to our initial description of the new technique established its safety and efficacy.

Assessment of the Effect of Chin Augmentation with Hyaluronic Acid Filler on Facial Soft Tissues Using Lateral Cephalometric Radiograph

Assessment of the Effect of Chin Augmentation with Hyaluronic Acid Filler on Facial Soft Tissues Using Lateral Cephalometric Radiograph

8. The Versatile Role of Fat Injection during Various Genioplasties

PURPOSE: Fat injection is increasingly common in aesthetic surgery due to autogenous volume augmentation, anti-inflammatory properties of adipocyte stem cells, regenerative potential, and restoration of youthful aesthetics. However, there is sparsity in the literature to the chin and corresponding complications. We report our experience with fat injection during chin surgery. METHODS: Data from our institution was collected from 2016-2022 for patients who underwent chin fat grafts and genioplasty alone. Patients with chin fat injection were divided into isolated chin fat injection (CFI), combined facial and chin fat injection (FFCFI) and those who underwent genioplasty or osteotomy in combination with chin fat injection (CFIO). Patient demographics and surgical details were compiled for each patient. Complications and reoperations were compared using Fischer’s exact test compared to genioplasty alone. RESULTS: A total of 181 patients were included in the final analysis, with 14 CFI patients, 130 FFCFI patients, 24 CFIO patients, and 13 patients who underwent genioplasty alone. Additional fat injections were required in 17 (9.4%) patients overall, which included 14 FFCFI patients (10.8%) and three CFIO patients (12.5%) (p=0.73). No patients who underwent genioplasty alone or CFI required reoperation. There were no significant differences in complications between the genioplasty-alone (0%) in comparison to the CFI (7.1%; p=1.00), FFCFI (8.3%; p=0.53), or CFIO cohorts (7.7%; p=1.00). CONCLUSION: Fat injection provides options for augmentation on patients as either an isolated procedure or in combination with osteotomies for enhanced aesthetic outcomes, and has low complication rates.

Nonsurgical Chin Augmentation Using Hyaluronic Acid: A Systematic Review of Technique, Satisfaction, and Complications.

Nonsurgical chin augmentation using hyaluronic acid (HA) has become a common procedure in cosmetic practices. This is offered to patients that prefer a nonsurgical, temporary method to correcting underdeveloped or retruded chin and restoring the volume loss. This systematic review highlights the main HA injection technique and associated patient satisfaction and complications of chin augmentation to further guide practitioners. A systematic review was performed according to PRISMA guidelines. PubMed, Embase, and Web of Science were searched using the appropriate keywords. Data collected from each study included patient satisfaction and complications, in addition to injection protocol and technique. A total of 1305 studies were found based on search criteria. After full-text screening for inclusion and exclusion criteria, 8 studies were included. A total of 917 patients underwent HA chin augmentation, with different injection protocols. Most patients were satisfied with the results, and there were only 2 relatively major complications reported. The most common adverse events were local responses at the injection sites (swelling, bruising, pain, redness, and itching). There were no reports of vascular complications. HA filler is an effective temporary method to correct chin retraction and absorption for chin augmentation, with a high degree of patient satisfaction and a low risk of severe complications. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .