Genioplasty Research Articles

Reconstitution of craniofacial osseous contour deformities, sequelae of trauma and post resection for tumors, with an alloplastic-autogenous graft.

Our experience using a new technique for reconstructing contour defects of facial bones has been presented. It employs particulate, cancellous bone and an implantable prosthesis accurately fabricated of polyether urethane and polyethylene terephthalate cloth mesh which can be produced in a variety of configurations. A mannequin made of these materials displaying the various parts of the craniofacial complex that have been restored or are currently under investigation is shown in Figure 10. Large cranial vault defects, orbital floors, mandibles including chin augmentation, and nasal bone deformities have been successfully restored in man. Restoration of the pinna of the ear is currently being evaluated in laboratory animals.

Proplast chin augmentation

A method of chin augmentation employing a newer synthetic material (Proplast) is presented. The characteristics and biocompatibility of Proplast are detailed. Technical considerations and results of short term clinical trials in 20 patients are discussed. One implant necessitated removal secondary to trauma four months after surgery. All other implants including over 30 additional cases have been without incident.

Craniofacial contour defect reconstruction with a dacron/urethane composite: an alloplastic tray for bone induction fabrication and application.

An alloplastic tray made of poly(ethylene terephthalate) cloth mesh and poly(ether urethane) used in conjunction with cancellous bone-chip grafts is the basis for this new method of reconstructing facial osseous contour defects. The tray can be prefabricated in quantity and at low cost for standard defects, such as discontinuity defects of the mandible or for chin augmentation. It can be custom-fabricated for specific defects in individual patients as, for example, gunshot wounds to the forehead. The materials were chosen because of their known histocompatibility, the ease of fabrication, and because the materials can be molded to form esthetic contours. The can be easily modified at the time of surgery. Sterilization is by autoclaving. Initial studied were undertaken in mongrel dogs where mandibular discontinuity defects in the range of 2-4 cm were reconstructed. In man, the technique has been used to reconstruct discontinuity defects of the mandible ranging in size from 1.5-12 cm in 16 patients. Atrophic mandibular alveolar ridges have been augmented using this technique in 7 patients, thus providing an adequate alveolar ridge for dentures. Two patients with defects of the skull secondary to gunshot wounds have had frontal bone restoration using this method. Reconstructions of the ear, the chin, and the orbital floor are currently being evaluated. This technique overcomes many problems of esthetic contour reconstruction and combines the use of autogenous cancellous particulate bone and a tissue-compatible synthetic composite material.

Adjunctive Measures in Rhinoplasty

Modern day rhinoplasty demands more than a plan for a new nose. It requires consideration of the individual in terms of a new facial image. Adjacent skeletal and soft tissue weaknesses must be evaluated along with the primary nasal deformity. Frequently facial disharmonies may be corrected with relatively simple operative procedures or with cosmetics. When the procedure does not measurably increase the operative time, postoperative morbidity, or financial cose of the rhinoplasty, it will be more readily accepted by the patient. These criteria are considered in the suggested methods of chin augmentation with alloplastic implants and reduction mentoplasty, utilizing the intraoral subapical horizontal osteotomy of the mandible. At times, simple methods of camouflage will be inadequate. Significant jaw disharmony with unacceptable occlusion requires the interdisciplinary teamwork of the orthodontist, the surgeon, and possibly the prosthodontist. In these cases rhinoplasty waits upon skeletal and dental realignment. Almost without exception, the rhinoplasty patient appreciates and profits from the surgeon's concern over her general appearance. Advice regarding skin care, makeup, hair styling, and facial rejuvenation frequently aids that person in attaining a happy and satisfying rhinoplastic experience.

The use of silicone chin implants in plastic surgery

The use of silicone chin implants in plastic surgery

The use of silicone chin implants in plastic surgery: a method of chin augmentation.

The use of silicone chin implants in plastic surgery: a method of chin augmentation.

Notes on Esthetic Surgery in the Indonesian

A brief overview of the following conditions and procedures is presented: the scar, Oriental eyelid surgery, rhinoplasty, prominent ears, rhytidectomy, silicone fluid injection, mammaplasty, and chin augmentation.

Avoiding bone resorption under plastic chin implants.

Bone resorption associated with chin augmentation procedures is thought to be due to pressure on the bone exerted by the implanted materials. A technique minimizing such pressure is described, using multiple small, soft silicone rubber (Silastic) sponge implants, inserted extra-orally with minimum undermining immediately above the periosteum. Postoperative examinations have revealed no indications of bony changes in patients subjected to this technique.

Organic Polymer Biocompatibility and Toxicology

Abstract Adverse effects of organic polymers used for plasma extenders, tissue adhesives, bone cements, contraceptive devices, prostheses, artificial organs, food packaging, cooking, and laboratory ware are appraised. Parenteral polymer disintegration involves hydrolytic, redox, and degradation reactions. Accumulative toxicity of plasticizers, antioxidants, and monomers liberated from plastic containers warrants investigation. Main problems with heart-assist devices are clotting and blood destruction; with plasma extenders, thesaurismotic reactions; with acrylic bone glues, transitory hypotension; with artificial kidneys, loss of metabolic essentials; with silicone heart valves, uptake of lipids; with silicone chin implants, bone resorption; and with liquid silicone mammary amplification, lumpy breasts and mastitis. A polymer fume fever is linked with pyrolysis of polytetrafluoroethylene. Human solid-state carcinogenesis constitutes a calculated risk with polymer implants. In rodents, all solid polymers tested produced cancer; chemical carcinogenesis was induced by a polyvinyl chloride copolymer, vinyl chloride, polycaprolactam, liquid silicone, and some brands of polytetrafluoroethylene.

Bone resorption under plastic chin implants. Follow-up of a preliminary report.

Discovery of bone resorption in a patient who had a plastic chin implant prompted the recall and roentgenographic examination of other patients with chin implants. Eleven of 25 showed bone resorption. One of the 11 had bony encapsulation of the implant. Patients for whom plastic chin implants are contemplated must be told of the possibility of bone resorption so that they can give informed consent to the procedure. The surgeon should also check the success of such implants with periodic radiographic examinations.

Surgical-orthodontic treatment of severe mandibular retrusion

1. 1. Since severe mandibular retrusion cannot always be successfully corrected by orthodontic means alone, various surgical approaches should be considered. These include maxillary osteotomy, chin augmentation, and anterior repositioning of the mandibular body. 2. 2. Problems of mandibular deficiency can be treated by anterior mandibular positioning, although considerable posterior readjustment may be encountered because of suprahyoid muscle pull. 3. 3. Three cases are presented to illustrate various aspects of the short- and long-term changes observed with this technique. The surgical technique used was the bilateral sagittal-split osteotomy. 4. 4. To maintain maximum correction with this technique, it is suggested that the mandibular body be well rotated forward at the time of surgical intervention and overcorrected anteriorly as much as possible. The use of a shoulder-to-chin brace is also recommended.

A new technique of chin augmentation.

A new technique of chin augmentation.

The orthodontist's role in surgical correction o f dentofacial deformities

M ost surgical techniques in use today for the correction of orofacial deformities and malocclusion are modifications of procedures developed before World War II by oral and plastic surgeons, primarily in Europe and to a lesser extent in the United States. In spite of the voluminous literature on the subject, diagnosis, treatment planning, and evaluation of treatment results have received scant attention, and only recently have these parameters been defined with greater precision, primarily because orthodontists have been included in the surgical team. The orthodontist has contributed to the assessment of dentofacial morphology and malocclusion by emphasizing the need for careful correlation of clinical findings, cephalometric analysis, and evaluation of dental casts to arrive at an analytical diagnosis and a basic approach to treatment. The orthodontist has also been able to predict treatment results and document anticipated changes with considerable accuracy. Moreover, meaningful evaluation of facial prognathism in lateral head radiography and profile photography has been facilitated through the use of “natural head positioning “I and the grid method of cephalometric analysis.2 The collaboration between orthodontist and oral surgeon results in an objective approach to the selection of therapeutic measures in which all aspects of diagnosis, prognosis, therapeutic modifiability, indications, and contraindications for treatment are jointly considered. Present surgical methods are essentially variations of three basic approaches, namely, cosmetic or masking procedures, maxillary dentoalveolar techniques, and several mandibular operations (Fig. 1). Cosmetic surgery is often the simplest and least traumatic kind of correction, and it includes genioplasties (reshaping), chin implants (allogenic and autogenic), labioplasties, and rhinoplasties (requiring the services of a plastic

Calibrated chin augmentation.

A SIMPLE and exacting procedure is described for augmenting a receded chin by means of implants through calibration (Fig 1, A ). Various methods have been advocated for the insertion of a prosthesis or graft without taking into account accurate measurements for their final alignment. Because of this discrepancy many reconstructed chins ultimately assume a distorted appearance. It is with this in mind that this procedure is advanced so as to assure a more accurate and pleasing result. Procedure After the patient is properly draped, a sterile Methylene blue stained applicator is used to lightly draw a line beginning from the base of the columella of the nose down through the center of Cupid's Bow of the upper lip and continued through the centers of the lower lip and chin (Fig 1, B ). Following this a horizontal line is drawn across the chin along the path of the future position of

Profile reconstruction with Silastic chin implants

A c o N o E P T of facial esthetics has long been an integral part of orthodontic treatment. In his fifth edition of Regulation of the Teeth, Angle1 suggests that “all who hope to attain success in the treatment of dental irregularities should cultivate the habit of observing and carefully studying the normal and abnormal lines of the human face, together with their relations to, and dependence upon, the teeth. ” The importance of the nose-chin-lip relationship is described whenever softtissue esthetics is evaluated. We believe that there is a need for greater communication between the orthodontist and the maxillofacial surgeon or otolaryngologist to develop a true concept of complete profile reconstruction. Patients with facial deformities usually are not aware that there may be a problem with either the teeth, the nose, or the chin. The potential for growth and development inherent in the young orthodontic patient may never be realized. The question resolves itself into one of responsibility. How much responsibility should the orthodontist assume for soft-tissue development? It is commonly agreed today that the movement of teeth will result in alveolar bone remodeling, but any influence on growth beyond the alveolar bone is subject to considerable controversy. Subtelny2 reported that growth changes are expressed in the areas of the nose, the chin, and the lips. He further states: “The soft tissue changes that we can anticipate, incident to treatment, will center around the lips, primarily in the vermillion area. ” With respect to chin size, Garn and associates3 reported that the data they collected suggested genetic simplicity for symphyseal thickness. Humbleton cautions that “although the drape of the soft tissue can be changed dramatically by orthodontic treatment, it must be remembered that many changes will take place regardless bf orthodontic treatment, ” and let me add to this in spite of orthodontic treatment. I do not suggest that there should be a lessening of the meehanotherapeutic at-

Progress in nasal and chin augmentation.

Progress in nasal and chin augmentation.

PROFILE-PLASTY. REPORT ON PLASTIC CHIN IMPLANTS.

The LaryngoscopeVolume 74, Issue 1 p. 144-154 Article Profile-plasty. Report on plastic chin implants Benito B. Rish M.D. F.A.C.S., Benito B. Rish M.D. F.A.C.S. 860 Fifth Ave. New York, N. Y.Search for more papers by this author Benito B. Rish M.D. F.A.C.S., Benito B. Rish M.D. F.A.C.S. 860 Fifth Ave. New York, N. Y.Search for more papers by this author First published: January 1964 https://doi.org/10.1002/lary.5540740119Citations: 5AboutPDF 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 onFacebookTwitterLinked InRedditWechat Citing Literature Volume74, Issue1January 1964Pages 144-154 RelatedInformation

Chin implants with a newer plastic compound.

Introduction The relationship of the chin profile to the nasal profile is an important one and has a determining effect on the final aesthetic effect of a rhinoplasty. Therefore, alteration of micrognathia by augmentation and other plastic chin revisions is an important part of any attempt to change the aesthetic appearance of an individual who complains of an ugly nose. This paper discusses the relationship of the nasal and chin profiles to the total face configuration and reports on the use of a new material, Silastic * (Dow-Corning), that has proved to be ideal for augmentation of micrognathia where this procedure is indicated for alteration of facial configuration. Human beings have been concerned with the aesthetic appeal of their appearance since antiquity. The facial appearance, especially the profile, is considered by many individuals to be the most important outward manifestation of their beauty, and, certainly, the millions of dollars spent annually

Alloplastic materials in the creation of facial contour. A preliminary report on acrylic chin implants.

Cosmetic surgery not only demands surgical skill but also taxes the surgeon's ingenuity and judgment in the final attainment of satisfactory results. The ultimate results, of course, will vary between operators, and variations must of necessity exist which will depend on the patient's over-all facial configuration. It is imperative not to follow any definite pattern or patterns; freedom in desire and judgment must be present. Two separate operators may view a profile in complete opposite cosmetic aspects. We described the importance of the relationship which was termed the nose-chin profile in a previous publication where we advocated the use of preserved costal cartilage for the correction of the receding chin. 1 Emphasis was placed on the necessity of altering the chin in direct proportion to the nasal correction. Oftentimes it is of greater importance to correct the chin deformity than to correct the nasal problem. 1-4 Patients are seldom aware