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Original Investigation |

A Simplified, Reliable Approach for Advancement Genioplasty

David Chan, MD1; Yadranko Ducic, MD, FRCSC1
[+] Author Affiliations
1Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
JAMA Facial Plast Surg. 2016;18(2):114-118. doi:10.1001/jamafacial.2015.1818.
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Importance  Advancement genioplasty is a versatile procedure able to address both functional and cosmetic issues. It is commonly performed by oral surgeons and less so by facial plastic and plastic surgeons, presumably because of its inherent risks.

Objectives  To present our technique for advancement genioplasty and our aesthetic and functional outcomes.

Design, Setting, and Participants  A retrospective review was conducted of the medical records of 126 patients who had undergone advancement genioplasty with our modified technique in a private practice setting from September 1997, through September 2014. Our analysis was performed between January and March 2015.

Main Outcomes and Measures  Description of technique and evaluation of complication rates, improvement in sleep apnea symptoms, and patient satisfaction.

Results  The 126 patients had a mean age of 39.8 years. There were 81 male and 45 female patients. The overall complication rate was 6.3% (8 of the 126 patients). Complications included plate extrusion in 2 patients, infection in 2 patients, mental nerve injury in 3 patients, and tooth root injury in 1 patient. Patients were satisfied with the aesthetic result of the procedure, which also produced an improvement in obstructive sleep apnea in 82 of 89 (92%) patients with sleep apnea.

Conclusions and Relevance  Advancement genioplasty is a valuable tool that can address both functional and aesthetic issues. The technique presented here allows safe, reliable, and effective execution of the procedure.

Level of Evidence  3.

Figures in this Article

Figures

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Figure 1.
Markings for Osteotomies

Markings depict the boundaries for the saw cut. The lateral boundary is marked by a vertical line drawn the mental foramen. The horizontal boundary is a line marked inferior to the tooth roots. The midline is marked. Reproduced with permission from Alexandra B. Hernandez of Gory Details Illustration.

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Figure 2.
Angulation of Osteotomy

Angulation of the saw cut based on the boundaries decreases the risk of injury to the mental nerve. Reproduced with permission from Alexandra B. Hernandez of Gory Details Illustration.

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Figure 3.
Advancement and Fixation of the Mandible Segment

The advancement segment maintains contact with the mandible and is secured using 2 step plates. Reproduced with permission from Alexandra B. Hernandez of Gory Details Illustration.

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