Chin Aesthetics – Orthognathic Surgery

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Chin is the area which is in lower part of our face, and establishes connection between the face and neck. It provides not only visuality, also the opening and closing function of our mouth by the help of joint it makes with the head. Also the chin has importance in terms of aesthetics for the facial area. Like nose, the gonion should also be proportionate and compatible with the other facial areas. It is one of the important structures composing profile of the face.

Orthognathic surgery or chin aesthetics is the procedure of fixing disorder with intervention oriented chins of the patients with the problem of biting and chewing based on the disorder in their teeth alignment.

The most important case in the plastic surgeries performed in the chin is the teeth alignment-closure and if it is a situation concerning the whole chin. If the teeth alignment, chin closure is normal and it is a case only concerning the gonion, different surgery; and in cases that teeth alignment and closure are out of order, surgeries concerning the whole chin are performed.

Conditions affecting the development of the whole chin

Micrognathia, besides stating small chin, is the mandibula hypoplasia, the small mandibula occurred depending on pause depending growth and development of the mandibula. Retrognathia is used in stating the lower jaw with back placement and which there is no change in sizes. Prognathism describes the cases that the lower jaw is in front compared to the upper jaw in the closed mouth position; there is a disorder in the whole chin, not only in the gonion, and the lower jaw teeth are more ahead than the upper jaw teeth in the patient.

Conditions affecting only development of the gonion

Microgenia or small chin progresses depending on insufficient development of the mental symphysis. Microgenia is an isolated deformity, differently from micrognathia, rest of the chin is normal. Macrogenia describes overdevelopment of the chin. Development of this region progresses independently from other parts of the mandibula.

Teeth Alignment – Closure Are Normal Gonion Is Behind (Microgenia)

If the patient’s teeth alignment and closure of the chin are in normal position, different surgical techniques can be used to fix this situation. The one I frequently use among these is the surgery of enlarging the gonion by putting implant like medpor, silicone etc. in the gonion. I frequently prefer the medpor implants providing nearly full ossification.

Because the surgical incision is made from inside of the mouth, there is not any trace left. It is necessary to eat soft foods for about 1 week. It is a surgery of which conclusion is quite pleasing. Sometimes a jowl appearance called “bird face” may also be in the necks of the patients whose gonion is back. In this case, liposuction of the neck can also be performed according to the need.

Again one of the surgeries performed to bring the gonion forward is the genioplasty, gonion feed surgery. In this surgery, tip of the chin is cut, brought forward, and the jaw fixation is provided with plaque and screws.

Teeth Alignment – Closure Are Normal Gonion Is Ahead (Macrogenia)

If the patient’s teeth alignment and closure of the chin are in normal position and only the gonion is ahead, horizontal pulling back osteotomy is performed to fix this situation. In other words, tip of the lower jaw is cut, some amount of bone tissue is removed, and the gonion is determined with plaque and screw so as to pull it back. Because the surgical incision is made from inside of the mouth, there is not any mark left. It is necessary to eat soft foods for about 1 week. It is a surgery of which conclusion is quite pleasing.

Teeth Alignment – Closure Are Disordered Lower Jaw Is Ahead (Prognathism)

If there is closing disorder in the patient’s chin, teeth in the lower jaw are more ahead than the upper jaw; in this situation, both orthodontia and surgery are required. The surgery performed in this case is called as “set back sagittal split osteotomy”.

Before this surgery, the plastic surgeon works together with an orthodontist regarding teeth alignment. How an intervention should be performed in the lower or upper jaws shapes with inspection and cephalometric measurements made. After this stage, the orthodontist makes preoperative preparations by putting brace on teeth. This is a process may take several months. It is waited until the patient becomes completely ready for the surgery.

In the surgery, upper and/or lower jaw bone (maxilla and/or mandibula) are broken from the appropriate areas. In accordance with the ideal position of teeth should come, with a mold prepared by the orthodontist, new shape is given to the teeth and consequently the chin. In order to protect this shape, the bone is determined from appropriate places with plaque and screws.

After the surgery, the lower and upper teeth are braced each other for a while until the chin heals in its new shape. In this period, it is fed only with liquid foods. Because the all sutures in the mouth are in type of dissolving by themselves, they do not need to be removed. Swelling occurred depending on the surgery reduces rapidly within a few days. In the following period, orthodontic treatment concerning the teeth continues some more time.

Teeth Alignment – Closure Are Disordered Lower Jaw Is Behind (Retrognathia)

If there is closing disorder in the patient’s chin, teeth in lower jaw stay behind than the upper jaw; in this situation both orthodontia and surgery are required. The surgery performed in this situation is called as “feeding sagittal split osteotomy”.

Before this surgery, the plastic surgeonworks together with an orthodontist regarding teeth alignment. How an intervention should be performed in the lower or upper jaws shapes with inspection and cephalometric measurements made. After this stage, the orthodontist makes preoperative preparations by putting brace on teeth. This is a process may take several months. It is waited until the patient becomes completely ready for the surgery.

In the surgery, upper and/or lower jaw bone (maxilla and/or mandibula) are broken from the appropriate areas. In accordance with the ideal position of teeth should come, with a mold prepared by the orthodontist, new shape is given to the teeth and consequently the chin. In order to protect this shape, the bone is determined from appropriate places with plaque and screws.

After the surgery, the lower and upper teeth are braced each other for a while until the chin heals in its new shape. In this period, it is fed only with liquid foods. Because the all sutures in the mouth are in type of dissolving by themselves, they do not need to be removed. Swelling occurred depending on the surgery reduces rapidly within a few days. In the following period, orthodontic treatment concerning the teeth continues some more time.