CHIN SURGERY OR GENIOPLASTY

Chin surgery, also known as genioplasty, is a cosmetic surgical procedure that aims to modify the shape and the position of the chin to make the profile of the face more harmonious. Genioplasty also provides functional improvement on breathing and on the occlusion of the lips.

The genioplasty can be performed either by osseous section (called osteotomy) or by placing a chin implant.

The genioplasty can be performed at the same time as a rhinoplasty, which will harmonize the profile of the face hence the name of cosmetic profile surgery or profiloplasty, when rhinoplasty and genioplasty are associated.

Genioplasty may also be performed as part of an orthognatic jaw surgery (maxillary and / or mandibular osteotomy).

The aim of this procedure is to give the chin a natural appearance that harmonizes with the other facial features, fitting the patient’s psychology and personality and responding to his or her expectations.

The medical consultation will take place at Laclinic-Montreux, or at the Beauty Suite in Lausanne, (near Geneva by train).

Careful questioning and a thorough clinical examination will allow to understand the patient’s motivations and wishes.

In order to prepare the surgery, Doctor Jean-Charles BAYOL will take photographs and make x-rays of the face and the profile (teleradiography) and analyze the measurements and the angles (Figure 1).

Figure 1: Cephalometric analysis of a profile teleradiography

This cephalometric analysis will simulate the exact position of the chin in the facial architecture and the overall harmony of your face.

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The surgical procedure will take place in the operating room under general anesthesia, following a regular hospitalization at Laclinic in Montreux with postoperative monitoring the night after the procedure and a check-out on the next day.

Located in the mouth at the bottom of the vestibule of the lower lip buccal mucosa, the scar is most often invisible. When the option of placing a chin implant has been chosen, a short scar can be made under the chin.

The chin bone is cut under the dental roots in order to preserve the vitality of the teeth. Once released, the chin can be moved further up, down, forward, or backward (in rare cases). It will be fixed with micro-screws that will not need to be removed (Figure 2).

Figure 2: Genioplasty fixing

If it has been decided to install a chin implant, it will be slid in the proper position and may also be stabilized by one or more screws.

The endo-buccal scar is then closed with resorbable sutures that will disappear within 2 to 4 weeks.

When the genioplasty is performed alone, the procedure lasts about one hour.

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Immediately after surgery, some endo-buccal bleeding is frequent but should not alarm you. There is often a swelling of the lower part of the face (lip, chin and neck) and bruises that can be important. The sensitivity of the lower lip and teeth, as well as the mobility of the lower jaw, are diminishing a few days after the procedure.

To reduce the importance of edema and bruises, you will be systematically taken care of by the department of physiotherapy, for a postoperative care. The check-out will happen on the same day, in the case of an outpatient hospitalization, or the next day, if you stay in hospital overnight. Gentle massages of the operated areas and LED care will ensure the lymphatic drainage and will promote the healing process. Several weeks after the procedure, an LPG treatment can be undertaken on the areas where the fat tissue has been collected.

Simple analgesic treatments will help relieve pain. Antibiotic treatment may be prescribed.

It is important to have an excellent oral hygiene combining mouthwashes and tooth-brushing with a soft toothbrush so that there is no local infectious complication.

Regular clinical and radiological monitoring will be scheduled after surgery to ensure that the bone fragment is fixed in its proper position and does not move.

Sports activities can be resumed between 1 month and 1 month and a half after the procedure.

Bone consolidation is achieved in 6 to 8 weeks.

It is important to remember that the displacement of the chin modifies the appearance of the face in a more or less important fashion.

It takes 2 to 3 months to get a good idea of the clinical outcome. The final result will be obtained in about 6 months, when the edema has completely disappeared.

These imperfections may result from a misunderstanding regarding the objective to be achieved due to an unusual cicatricial phenomena or unpredictable tissue reactions.

If they are not tolerated by the patient, imperfections can be corrected by slight retouching, much simpler than the initial procedure. However, surgical retouching cannot be considered for 6 months to one year after the initial procedure, until the tissues are well healed and stable.

A cosmetic surgery of the chin and profile, although carried out for aesthetic motivations, remains nevertheless, a real surgical act, which involves risks associated with any medico-surgical procedure.

More than any other cosmetic surgery, it is fundamental to choose a surgeon qualified in maxillofacial surgery and facial cosmetic surgery to perform a genioplasty. Choosing Dr. Jean-Charles BAYOL, who has been trained in this type of surgical procedures will limit these risks to the maximum, but do not completely eliminate them.

Fortunately, the complications of a chin cosmetic surgery are rare. In practice, the overwhelming majority of interventions take place without any concern and patients are fully satisfied with the outcome.

However, despite their rarity, you should be aware of possible complications:

• Bleedings: They can be important, even if they are very rare after this type of procedure. In case of very important bleeding, an early revision surgery may be necessary in order to stop it.
• Sensitivity loss: located in the lower lip, gum or teeth, they are common and will gradually fade, however recovery can take several months.
• Delayed bone consolidation: another procedure to perform a bone graft may sometimes be necessary.
• Dental lesions: in exceptional cases, dental roots can be damaged during the bone cutting and will require treatment (apical resection).
• Wasting of the bone fragment: very rare, the bone fragment can gradually resorb, resulting in the loss of the created relief. A secondary bone graft or the placement of a chin implant can be discussed and performed.
• Complications when placing a chin implant: Artificial implants (silicone, coral, etc.) may not be tolerated by the patient. Displaced or infected, because of the degradation and / or mobility, an ablation and a secondary reconstruction will be necessary.

Genioplasty or profiloplasty is a small surgical procedure that can transform the profile of your face, and is sometimes an indispensable complement to a rhinoplasty.

During his training, Dr. Jean-Charles BAYOL specialized in maxillofacial surgery and facial cosmetic surgery. He performs this procedure alone or combined with a rhinoplasty at Laclinic in Montreux where the whole team will take care of you, so that this operation is a real success!