Oranges Carlo M, Grufman Vendela, di Summa Pietro G, Fritsche Elmar, Kalbermatten Daniel F
From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, University of Geneva.
Department of Hand and Plastic Surgery, Luzern Cantonal Hospital.
Plast Reconstr Surg. 2023 May 1;151(5):758e-771e. doi: 10.1097/PRS.0000000000010079. Epub 2022 Dec 20.
Chin augmentation has maintained a high level of popularity among patients and facial plastic surgeons. Several procedures exist to enhance the appearance of a small chin. The aim of this study was to perform a systematic literature review to determine outcomes and complications associated with the different techniques described.
MEDLINE, PubMed, PubMed Central (PMC), and Cochrane Central Registry of Controlled Trials (CENTRAL) databases were screened using a search algorithm. The techniques were classified, and related outcomes and complications tabulated and analyzed.
A total of 54 studies on primary chin augmentation published from 1977 to 2020 met inclusion criteria, representing 4897 treated patients. Six main surgical techniques were identified: chin augmentation with implants (silicone, Gore-Tex, Mersilene, Prolene, Medpor, Proplast, hard tissue replacement, porous block hydroxyapatite, or acrylic; n = 3344), osteotomy ( n = 885), autologous grafts (fat, bone, derma, or cartilage; n = 398), fillers (hyaluronic acid, hydroxyapatite, or biphasic polymer; n = 233), local tissue rearrangements ( n = 32), and a combination of implant placement and osteotomy ( n = 5). All techniques provided consistently satisfactory cosmetic outcomes. The overall complication rate of the most represented groups was 15.7% for implants and 19.7% for osteotomy, including 2.4% and 16.4% cases of transient mental nerve-related injuries, respectively.
All described chin augmentation techniques achieved good outcomes with high patient satisfaction. Thorough knowledge of each technique is essential to minimize each procedure's specific complications. Caution is generally needed to avoid nerve injuries and potential overcorrection or undercorrection.
隆下巴在患者和面部整形外科医生中一直很受欢迎。有多种手术方法可用于改善小下巴的外观。本研究的目的是进行系统的文献综述，以确定与所描述的不同技术相关的结果和并发症。
使用搜索算法对医学文献数据库（MEDLINE）、医学期刊数据库（PubMed）、医学期刊数据库中心（PMC）和Cochrane对照试验中心注册库（CENTRAL）进行筛选。对技术进行分类，并将相关结果和并发症制成表格并进行分析。
1977年至2020年发表的共有54项关于初次隆下巴的研究符合纳入标准，共涉及4897例接受治疗的患者。确定了六种主要手术技术：植入物隆下巴（硅胶、戈尔特斯、涤纶、聚丙烯、Medpor、Proplast、硬组织替代物、多孔块状羟基磷灰石或丙烯酸；n = 3344）、截骨术（n = 特 885）、自体移植（脂肪、骨、真皮或软骨；n = 398）、填充剂（透明质酸、羟基磷灰石或双相聚合物；n = 233）、局部组织重排（n = 32）以及植入物放置和截骨术联合应用（n = 5）。所有技术均能持续提供令人满意的美容效果。最具代表性的两组的总体并发症发生率分别为：植入物组15.7%，截骨术组19.7%，其中分别有2.4%和16.4%的病例出现短暂性颏神经相关损伤。
所有描述的隆下巴技术均取得了良好效果，患者满意度高。全面了解每种技术对于将每种手术的特定并发症降至最低至关重要。一般需要谨慎操作以避免神经损伤以及潜在的过度矫正或矫正不足。
