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Original Article |

Combined Rhinoplasty and Genioplasty:  Long-term Follow-up

Dario Bertossi, MD; Massimo Albanese, MD; Matteo Turra, MD; Vittorio Favero, MD; Pierfrancesco Nocini, MD, DDS; Alessandra Lucchese, MD
JAMA Facial Plast Surg. 2013;15(3):192-197. doi:10.1001/jamafacial.2013.759.
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Importance Long-term follow-up reference for experienced clinicians dedicated to profileplasty.

Objective To evaluate the long-term results and complications of combined rhinoplasty and genioplasty.

Design Retrospective study including objective and subjective evaluation before and after 3 years of undergoing simultaneous open rhinoplasty and genioplasty among a cohort of 90 patients.

Setting Academic medical center.

Patients A total of 90 cases of combined rhinoplasty and genioplasty performed from January 2002 through January 2004 were reviewed to evaluate the stability of the esthetic result.

Main Outcome Measure Long-term stability of the esthetic outcome of the simultaneous open rhinoplasty and genioplasty.

Results Soft-tissue Pogonion projection to the true vertical line and mandibular height (mandibular incisor tip to menton) were recorded. As far as reduction genioplasty patients are concerned, 45.6% of the patient population had a 100% stability after 3 years (<0.25 mm resorption measured at the menton). On the other hand, if augmentation genioplasty patients are considered, 52.4% (22 patients with a vertical augmentation range from 4-6 mm; mean, 5.3 mm; and 25 patients with a sagittal augmentation from 6-8 mm; mean, 7.2 mm) had 100% stability after 3 years. The chin was stable with no more than 1 mm of recurrence.

Conclusions and Relevance The results of the study indicate that the combined approach in correcting the facial profile is an effective procedure to achieve a more harmonic and consistent clinical outcome. The recurrence rate of less than 1 mm on the chin bone measurements is relevant to support this statement. An aesthetically proportionate face is strongly determined by the nasal-cervical relationship when observing the patient's profile. Even after a successful rhinoplasty, the patient's face can lack aesthetic attractiveness. Combined rhinoplasty-genioplasty is usually the best solution, particularly for patients with microgenia. It provides optimum patient satisfaction with a low incidence of recurrence.

Level of Evidence 4.

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Figures

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Figure 1. Osteotomies in genioplasty.

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Figure 2. Patient 1. Anteroposterior preoperative front view of the patient.

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Figure 3. Patient 1. Lateral preoperative view, with slight nasal hump, flat columella, short chin.

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Figure 4. Patient 1. Postoperative frontal view, with good soft-tissue projection on the chin and nasal widening.

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Figure 5. Patient 1. Lateral postoperative view, with increased nasal frontal angle, good soft tissue redistribution on menton and in the submandibular area.

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Figure 6. Patient 2. Anteroposterior preoperative front view of the patient.

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Figure 7. Patient 2. Lateral preoperative view, with a nasal hump and retrogenia.

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Figure 8. Patient 2. Postoperative front view, with good soft-tissue projection on the chin and slight nasal widening.

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Figure 9. Patient 2. Lateral postoperative view, with a straight nasal dorsum, up-rotation of the nasal tip, an sliding advancement genioplasty.

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