Bimaxillary orthognathic surgery with concomitant genioplasty to correct orofacial deformities

AIM To evaluate the relationship between hard tissue surgery and the effect on the overlying soft tissue. This predicts final facial proportions and profile, and determines the amount of genioplasty movement needed in all three dimensions for optimal chin esthetics. SUBJECTS AND METHODS: Twenty-one patients, (13 females and 8 males), with a mean age of 25.2 years, treated by bimaxillary surgery with concomitant genioplasty. A Le Fort I osteotomy and bilateral sagittal split ramus osteotomy and osteotomies of the inferior border of the mandible for sagittal augmentation and reduction, vertical augmentation and reduction, transverse correction of the chin were performed. RESULTS: Following the Milan school protocol of data collection, model surgery, clinical and cephalometric evaluation, treatment planning in a three dimensional key, these surgical procedures enhanced the middle and lower third facial balances, both anteriorly and in profile, normalized the lower third of the face’s vertical and sagittal aesthetic relationships, and softened the face. Sliding set back, asymmetric, and grafted genioplasties are less predictable than advancement genioplasty. In fact soft tissue changes are more variable than those showed with mandibular advancement. CONCLUSION: Genioplasty is a useful versatile adjunctive surgical procedure to achieve aesthetical and functional results with the goal of overall facial harmony and balance.