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18-03-2013 | Surgery | Article

Combined chin and nose surgery optimizes clinical, aesthetic outcomes

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medwireNews: Combined genioplasty and rhinoplasty is an effective and aesthetic means of correcting chin and nose deformities, say researchers.

"Even after successful rhinoplasty, the patient's face can lack aesthetic attractiveness," comment Dario Bertossi (University of Verona, Italy) and colleagues.

"Combined rhinoplasty-genioplasty is usually the best solution, particularly for patients with microgenia," they state in JAMA Facial Plastic Surgery.

Bertossi and colleagues preformed a retrospective study of 90 cases in which genioplasty was performed at the same time as rhinoplasty between January 2002 and January 2004. The mean age of patients was 27.7 years, ranging from 18 to 49 years. Fourteen patients received surgery for an undersized jaw (micrognathia), 33 patients for the correction of receding jaws (retrognathia), and the remaining 43 patients had surgery for vertical chin hyperdevelopment.

"Comparing the patients' photographs and radiographs obtained before and after the procedure, good results can be seen," Bertossi and team report.

In total, 46% of patients had reduction genioplasty. The mean postoperative value measuring the lower incisor tip to soft-tissue Pogonion was 5.6. Importantly, 100% stability was observed after 3 years, with less than 0.25 mm resorption measured at the menton and a mean long-term postoperative value of lower incisor tip to soft-tissue Pogonion of 5.34 mm.

Of the remaining 54% of patients who underwent augmentation genioplasty, 22 had a vertical enlargement of the chin of between 4 and 6 mm (mean 5.3 mm) and 25 had a sagittal augmentation of between 6 and 8 mm (mean 7.2 mm). The mean postoperative soft-tissue Pogonion to the true vertical line value was 6.5 mm. There was a tendency for recurrence (<1 mm) at 3 years, however, with a mean postoperative soft-tissue Pogonion to the true vertical line value of 5.6 mm.

"The results of this study indicate that the combined approach in correcting the facial profile is an effective procedure to achieve a more harmonic and consistent clinical outcome," Bertossi and team suggest.

Performing genioplasty at the same time as rhinoplasty "provides optimum patient satisfaction with a low incidence of recurrence," the researchers note. They add: "By using a simultaneous nose-chin correction procedure, the patient does not have to undergo a second surgery, thus reducing postoperative discomfort and reducing the overall cost."

By Sara Freeman, medwireNews Reporter