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• W1984080468 abstract "It has been demonstrated previously that many individuals requesting chin enlargement have small or retruded mandibles. A weak chin may be only one aspect of this particular class II skeletal deformity, the other components being a procumbent, retrusive lower lip, excessive labiomental fold depth, and decreased to normal lower face height. To avoid unaesthetic results, the chin should not be advanced beyond the retrusive lower lip, the only component over which osseous genioplasty has no control. This may result in residual sagittal “weakness” of the lower face, for which visual compensation can be achieved by vertical overelongation of the chin. Thirty-two patients requesting chin enlargement presented with the aforementioned class II deformity. Twenty patients had decreased lower face height and 12 patients had normal lower face height. Preoperative soft-tissue cephalometric analysis documented physical findings. The extent of sagittal chin movement was planned to advance the soft-tissue pogonion no further than the lower lip. Vertical chin movement was intentionally designed to overelongate the lower face relative to the mid-face in all patients. Radiographs were repeated at a mean 8.2 months following surgery to document skeletal displacements. Mean chin advancement was a modest 4.2 mm (2− to 7-mm range), and chin vertical displacement was a mean 7.9 mm (5.5− to 9-mm range). All patients had residual sagittal disproportion of the pogonion relative to the subnasale (-7.6 mm mean) and newly created vertical disproportion with mean lower face heights of 69.8 mm compared with mean midface heights of 64 mm. Despite only modest advancement of the pogonion, there was a marked increase in the apparent size of the lower face. Although labiomental fold depth decreased visually, it remained well defined in all patients. Sliding genioplasty can be used to effectively camouflage the visual perception of a “weak chin” in most patients with a class II skeletal pattern. However, it cannot correct the retrusive lower lip. Avoidance of unnatural, “overcorrected” appearances can only be achieved by recognizing this limitation and restricting forward movement of the chin so as not to advance it beyond the lower lip. One therefore must be willing to accept residual facial disproportion; i.e., the chin will remain sagittally weak relative to the upper lip and midface. Visual compensation for this disproportion in the anteroposterior plane can be achieved readily by creating vertical disproportion, i.e., vertical elongation of the chin and lower face beyond normative standards. Excessive height of the lower face can be aesthetically pleasing in the presence of a well-defined labiomental fold unaccompanied by lip strain." @default.
• W1984080468 created "2016-06-24" @default.
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• W1984080468 date "1995-03-01" @default.
• W1984080468 modified "2023-09-26" @default.
• W1984080468 title "Aesthetic Guidelines in Genioplasty" @default.
• W1984080468 doi "https://doi.org/10.1097/00006534-199503000-00004" @default.
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