Dekker Paige K, Slamin Robert P, Charipova Karina, Harbour Patrick W, Talbet Joseph H, Abdel Azim Sara, Baker Stephen B
Georgetown University School of Medicine, Washington, DC, USA.
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA.
Aesthet Surg J. 2022 Dec 14;42(12):NP730-NP744. doi: 10.1093/asj/sjac160.
The chin plays a critical role in the shape, projection, and soft tissue support of the lower face. Osseous genioplasty is a powerful tool in facial rejuvenation as it allows for optimal control of the resulting chin dimensions and improvement in submental and submandibular laxity. Osseous genioplasty can be used alone or in combination with other facial rejuvenation procedures to achieve an optimal result.
The aim of this study was to present the senior author's approach to skeletal analysis of the lower facial third and propose an algorithm that can be used to optimize skeletal support of the overlying soft tissue laxity while maintaining an aesthetic facial shape and proportion of the chin.
All patients undergoing cosmetic osseous genioplasty for soft tissue rejuvenation of the lower face and/or perioral region with the senior author between 2010 and 2021 were retrospectively reviewed. Complications, including infection, numbness, and prolonged ecchymosis, were recorded.
A total of 37 patients underwent cosmetic osseous genioplasty. The average age of the cohort was 44.5 years. Twenty-six patients (70.3%) were female. Eleven patients (29.7%) underwent genioplasty alone. In addition to genioplasty, 8 patients (21.6%) underwent orthognathic surgery, 5 patients (13.5%) underwent platysmaplasty and liposuction, and 2 patients (5.4%) underwent facelift. The authors propose an algorithm to guide evaluation of the lower facial third to help determine the possible role of osseous genioplasty for facial rejuvenation based on each patient's unique facial characteristics.
In properly selected patients, osseous genioplasty can improve lower facial projection, submandibular laxity, and perioral soft tissue support while also optimizing facial shape and proportion.
下巴在下面部的形状、突出度及软组织支撑方面起着关键作用。骨性颏成形术是面部年轻化的有力工具，因为它能对最终的下巴尺寸进行最佳控制，并改善颏下和下颌下的松弛状况。骨性颏成形术可单独使用，也可与其他面部年轻化手术联合使用以达到最佳效果。
本研究的目的是介绍资深作者对面部下三分之一进行骨骼分析的方法，并提出一种算法，该算法可用于优化覆盖软组织松弛的骨骼支撑，同时保持美观的面部形状和下巴比例。
回顾性分析了2010年至2021年间与资深作者一起接受用于下面部和/或口周区域软组织年轻化的美容性骨性颏成形术的所有患者。记录包括感染、麻木和长期瘀斑在内的并发症。
共有37例患者接受了美容性骨性颏成形术。该队列的平均年龄为44.5岁。26例患者（70.3%）为女性。11例患者（29.7%）单独接受了颏成形术。除颏成形术外，8例患者（21.6%）接受了正颌手术，5例患者（13.5%）接受了颈阔肌成形术和抽脂术，2例患者（5.4%）接受了面部提升术。作者提出一种算法来指导对面部下三分之一的评估，以帮助根据每位患者独特的面部特征确定骨性颏成形术在面部年轻化中的可能作用。
在适当选择的患者中，骨性颏成形术可改善下面部突出度、下颌下松弛及口周软组织支撑，同时还能优化面部形状和比例。
