Genioplasty Research Articles

Free autogenous pearl fat grafts in the face--a preliminary report of a rediscovered technique.

Free autogenous fat grafts between 4 and 6 mm (the size of a pearl) have been used successfully to correct pitting acne, nasolabial folds, eyelid depressions, facial atrophy, facial wrinkles, depressed scars, and in chin augmentation. Theoretical measures taken to ensure the maximum amount of survival of donor fat include exogenous vitamin E, treatment with insulin, small size of grafts, and atraumatic antiseptic technique. Numerous supportive clinical, historical, and laboratory references are cited, dating from 1893. Considering the abundance of fat tissue available and the prolific amounts discarded during blepharoplasty, liposuction, lipectomy, and platysma cervical lift, fat should be reconsidered as the soft tissue substitute. This is a preliminary report and further study is needed.

Rehabilitation of the face in patients with Down's syndrome.

Fifty patients with Down's syndrome underwent surgery for improvement of the facial stigmata. Partial glossectomy, lateral canthoplasty, and nose, cheek, and chin augmentation were the common procedures. With a follow-up of 18 to 24 months, the results were recorded by a multidisciplinary team with similar judgments on the glossectomy, the most satisfactory procedure, and some discrepancy on the other procedures, canthoplasty, and cheek augmentation. There were no infections or extrusion of prostheses, and a rather high incidence of extrusion of prostheses, and a rather high incidence of bone resorption was noted in the mandibular area. The facial changes were satisfactory in the majority of the cases in both medical and nonmedical evaluation and improved self-confidence, especially in the older patients. The satisfactory results here presented advocate certain procedures for attenuation of the Down's syndrome stigmata and improvement of some functions by diminishing the size of the tongue.

Facial profileplasty by liposuction extraction.

Facial profileplasty can include the removal of abnormal fat deposits in the face and neck as an individual begins to age and, in many cases, the correction of chin projection to achieve a better neck-chin contour line. In this report we retrospectively analyze the complications and results from 142 patients undergoing facial liposuction alone or in combination with chin augmentation or rhytidectomy during a follow-up period of 14 months. The liposuction technique offers very low morbidity and is superior to conventional excisional methods.

Correction of skeletal Class II malocclusions with deep bite by rapid extrusion of posterior teeth

Patients with skeletal Class II malocclusions and deep bites can be difficult to manage properly. Dental compensations, mandibular retrognathia, vertical dysplasia of inadequate posterior alveolar growth, and compensating chin effects must be considered if one is to achieve ideal treatment results. The eleven cases presented were managed through a combination of surgery, orthodontics, and rapid extrusion of the posterior dental arches. The rapid extrusion process is begun during the surgical healing phase, thereby decreasing total treatment time. Other advantages include simplicity of the surgical procedure, acceptance by the patient, stability of the facial and dental results, and possible avoidance of additional chin surgery.

Submental liposuction extraction with hard chin augmentation.

Liposuction techniques utilizing fat extraction sculpturing of the neck and simultaneous chin augmentation are described herein. In young persons, extraction is carried out in the submental areas. In older patients, who have diffuse fat accumulations and less skin tone, extraction includes the submental and submandibular areas, along with dry tunneling to the lateral borders of the sternocleidomastoid muscle and inferiorly to the suprasternal notch. When the skin tone is poor, with excessive redundancy, combined rhytidectomy with both open and closed liposuction is performed. With liposuction submental sculpturing , necessity for chin augmentation is critical to tauten the submental skin and to give a better neck-chin angle. Hard chin implants are preferred over the soft gelatinous types. We utilized a hard acrylic implant ( Rish ) in all cases. Results obtained by the dual approach of submental fat suction sculpturing and hard chin augmentation have been excellent.

Chin augmentation with rhinoplasty: A tutorial dissertation: Davis PKB. Br J Plast Surg 36:204, 1983

Chin augmentation with rhinoplasty: A tutorial dissertation: Davis PKB. Br J Plast Surg 36:204, 1983

The Platysma Muscle: Anatomic Considerations for Aesthetic Surgery of the Anterior Neck

Our current principles for the treatment of anterior neck deformities originally evolved from cadaver dissections and clinical observations. These principles have been applied over the past seven years in nearly 100 patients. We combine as indicated submandibular lipectomy, excision of the submental fat pad, chin implantation, creation or tightening of the platysma muscular sling, and skin tightening and resection. The muscular sling is created or tightened anteriorly by approximation or imbrication of the platysma muscle in the midline. Skin is removed posteriorly, utilizing a complete or lower facelift incision. Using these techniques, we have not found posterior tightening of the platysma muscle or the creation of platysma flaps to be necessary, although we would certainly use them if other alternatives were ineffective.

Cosmetic Plastic Surgery in Nonwhite Patients

This work represents an assemblage of 13 papers presented at a seminar entitled Plastic Surgery for the Nonwhite Patient conducted in conjunction with the 1981 annual meeting of the National Medical Association. Among the disciplines represented by the authorship are dermatology, plastic surgery, ophthalmology, and otolaryngology. Chapter titles, which should be of special interest to the facial plastic surgeon, include (1) Hair Replacement in the Black, (2) Blepharoplasty in the Oriental and Black, (3) Face Lift—Chin Augmentation, and Cosmetic Rhinoplasty in Blacks, (4) Dermabrasion, Chemical Peel, Cheiloplasty, and (5) Keloid—Scar Revision. The cosmetic surgeon unaccustomed to operating on the nonwhite patient should find this a valuable source of basic information; however, those looking to this volume for a comprehensive reference source are likely to be disappointed. For example, one article addresses face lift, chin augmentation, and cosmetic rhinoplasty in eight printed pages and four pages of photographs.

Chin augmentation with rhinoplasty: a tutorial dissertation

Alteration of the nasal profile can seldom be undertaken without a consideration of the facial profile. The relationship of the nose, forehead, upper lip and chin, when taken together, will determine the harmony of the face and attempts to correct one part without reference to the whole may result in less than satisfactory results (Fig. 1). BALANCE

Reduction Mentoplasty

Reduction Mentoplasty

Chin augmentation--a restrospective study.

A retrospective study of 480 Silastic chin implants is summarized and analyzed. The surgeon's own variations on the operative procedure are detailed, including the staging of the simultaneous nose-chin operation in which the chin work is started first, with a temporary interval for hump removal, followed by termination of the chin work and a return to the nose operation. A variation in the handling of the Silastic implant is described in which parallel incisions are made on its inner side to avoid dead space and undesired tension. The results of the 480 cases are presented. The overall complications rate was 2.3%, though the total percentage of implants removed was only 1.46.

Pectoralis myocutaneous flap for chin augmentation.

Radical resection of the anterior portion of the oral cavity, including a portion of the tongue, floor of the mouth, mandible, and neck, has always been, and remains, a perplexing problem in immediate rehabilitation of the area of the oral cavity and mentum. In the past, these deformities were classified as "Andy Gump." Attempts at correction of this deformity are protracted and complex. The use of the pectoralis myocutaneous flap offers an improvement in the concept of mamagement in that it supplies a skin lining for the oral cavity and augments the chin and neck in a single-stage procedure that may be combined with the primary operation.

Chin advancement as an aid in correction of deformities of the mental and submental regions.

Six patients are presented demonstrating various uses of chin advancement (horizontal osteotomy of the mandibular symphysis and sliding advancement) for correction of mental and submental deformities. With preservation of muscular attachment to the posterior border of the advanced mandibular fragment, the author feels that there is an anterior pull on the cervical musculature that may complement the posterior pull of platysmal plication. The technique of chin advancement is described in detail and offers more versatility than the use of alloplastic chin implants. The author advocates the use of this direct osseous approach for purely aesthetic reasons as well as in the correction of maxillofacial and craniofacial malformations.

Mentoplasty--a clinical analysis of alloplastic implants.

Different types of alloplastic implants are currently being utilized in performing mentoplasty. A review of the literature points out the number of prostheses that have been used. Each type of material has inherit physical properties which determine its characteristics for use as a chin implant. The type of implant and method selected in chin augmentation depends upon accurate preoperative evaluation and full understanding of the properties of alloplastic substances. Five hundred and thirty-nine cases of chin augmentation utilizing different materials and methods were reviewed over a nine year period. The limitations of mentoplasty as well as the advantages, disadvantages, and in selected cases, the indications for the use of a particular implant are discussed.

“How i do it”—plastic surgery: Practical suggestions on facial plastic surgery: Helpful hints in augmentation mentoplasty

The LaryngoscopeVolume 90, Issue 10 p. 1740-1744 Plastic SurgeryFree Access “How i do it”—plastic surgery: Practical suggestions on facial plastic surgery: Helpful hints in augmentation mentoplasty† Morey L. Parkes M.D., Corresponding Author Morey L. Parkes M.D. Los Angeles, CA9201 Sunset Blvd., Suite 405, Los Angeles, CA 90069Search for more papers by this authorRaj Kanodia M.D., Raj Kanodia M.D. Los Angeles, CASearch for more papers by this author Morey L. Parkes M.D., Corresponding Author Morey L. Parkes M.D. Los Angeles, CA9201 Sunset Blvd., Suite 405, Los Angeles, CA 90069Search for more papers by this authorRaj Kanodia M.D., Raj Kanodia M.D. Los Angeles, CASearch for more papers by this author First published: October 1980 https://doi.org/10.1288/00005537-198010000-00021 † From the Department of Otolaryngology, University of California, Irvine. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Bibliography 1 Bell, W.: Correction of the Contour Deficient Chin. J. Oral Surg., 27: 110– 115, 1969. 2 Carling. G. A.: Personally Fabricated Chin Implants. Plast, Reconstr. Surg., 51: 121– 128. 1973. 3 Beekhuis, G. J.: “HOW I Do It,” Augmentation Mentoplasty with Polyamide Mesh. The Laryngoscope, 86: 1602– 1605, 1976. 4 Parkes, M. L.: Chin Implants with a Newer Plastic Compound. Arch. Otokryngol., 75: 429– 436, 1962. 5 Parkes, M, L., Kamer, F. M. and Merrin, M. L.: Proplast Chin Augmentation, The Laryngoscope, 86: 1829– 1836, 1962. 6 Parkes, M. L., Kamer, M. P. and Bassilios, M.: Experience with Gel-Filled Implants in Augmentation Mentoplasty. Arch. Otolaryngol., 103: 292– 293, 1977. 7 Friedland, J. A., Coccaro, M. P. and Converse, J. M.: Retrospective Analysis of Mandibular Bone Absorption Under Silicone Rubber Chin Implants. Plast, Reconstr. Surg., 51: 144– 151, 1976. 8 Brown, J. B., Fryer, M. P. and Ohlwiler, D. A.: Study and Use of Synthetic Materials Such as Silicones and Teflon® as Subcutaneous Prostheses. Plast. Reconstr. Surg., 26: 264– 279, 1960. Volume90, Issue10October 1980Pages 1740-1744 ReferencesRelatedInformation

Radiologic evaluation of irradiated cartilage grafts on the facial skeleton of sheep.

Augmentation mentoplasty is a commonly performed procedure for correction of retrognathia and microgenia. Implantable Silastic prostheses have become the mainstay of therapy, but have some disadvantages. One of the most important complications is erosion of the underlying mandible. An attempt was made to produce an experimental animal model to test the efficacy of irradiated costochondral cartilage in this regard. In order to prevent a biological material from eroding the underlying bone, the irradiated sheep cartilage grafts were placed subperiosteally, deep to a pair of large muscles of facial expression in five Suffolk sheep. Irradiated cartilage was used as the test material and merthiolate-treated cartilage as the control. Only 1 of the 20 grafts showed any absorption after 1 year, and this was only 1 mm in depth. Because of the meager amount of absorption of irradiated cartilage grafts, the ease with which they can be carved, and their ready availability, they would appear to be ideal implants for chin augmentation.

Oral animation in the decision for chin augmentation

Oral animation, such as opening and closing the lips, smiling, or laughing, leads to muscular tension over the skin and the soft tissues of the chin. The "S"-like labiomental line presents a variable scope of curves, from a full curve, through "lazy-S", to a straight line. The different profiles of the chin thus achieved enable the plastic surgeon during preoperative planning to decide whether or not to perform chin augmentation in addition to the required rhinoplasty. Anatomical, functional, and clinical data are presented and discussed.

Intraoral augmentation mentoplasty with a hinged silastic implant.

Considerable concern has been expressed in the past ten years of bone resorption secondary to alloplastic chin implants. Therefore, I describe a modification of the surgical technique and a type of implant. Twenty-five patients underwent augmentation metoplasty for moderate to severe microgenia during the past three years. Surgery was performed with insertion of a modified type of Safian's solid silicone implant with triangular wedges that were removed on the posterior surface, and the spaces that were created were replaced with soft, pore-closed, whit silicone sponge. All implants were inserted intraorally, since the central body was supraperiosteal, and the lateral extensions were subperiosteal. Two implants of the 25 cases were removed postoperatively because of infection. Nine patients were followed up for one to three years postoperatively with serial xerographic analysis of the chin implants.

Risks of facial plastic surgery in an otolaryngology program.

By reviewing 680 rhinoplasty, facelift, blepharoplasty, otoplasty, and chin implant procedures that were performed during a two-year period by UCLA Head and Neck Surgery (Otolaryngology) residents, we have found that the rate of major and minor complications compares favorably with that rate achieved by physicians in practice who have reported their results in the literature. Three hundred and sixty-eight rhinoplasties resulted in 1.6% major complications, 14.4% in minor complications, and 5.2% in revision surgeries. One hundred fourteen facelifts had 5.3% major complications, and 24.5% had minor complications. One hundred fifty-six blepharoplasties had no major complications, and 7.7% had minor complications; 21 chin implants resulted in no major complications, and 9.5% resulted in minor complications; and 21 bilateral otoplasties had no major complications, and 14.3% had minor complications, with 4.8% revisions.

Proplast genioplasty: a retrospective study with treatment recommendations.

The treatment results in 31 consecutive patients treated with Proplast for chin augmentation show good clinical succes with the implant. A critical analysis of treatment results reveals that attention to certain details of the preoperative evaluation, surgical technique, and postoperative care can make for impressive results. These facts are discussed.