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

Abstract

Summary: 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.

Clinical question/level of evidence: Therapeutic, IV.