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Dental implants Jaw surgery Lower jaw Upper jaw Widening of the jaws The chin Jaw angle Cheek bones Orthognathic classification Aesthetic facial surgery Snoring and sleep apnea

Jaw surgery - The chin

The chin is of vital importance in overall facial aesthetics, as are the cheekbones. The position of the chin influences and directs the whole architecture of the face. The chin area can be enhanced by a genioplasty or an implant. The surgery can be done in a single session or as a complement during orthognathic procedures. The genioplasty takes 30-60 minutes. Anther way to enhence the area is with an implant. The best way here is a PEEK implant, computer designed and patient specific. The peek implant has the advantage that the flow of the mandibular lower border can be made totally natural without bumps or flow disruptions. But this has to be discussed with the surgeon, who can prefer the one over the other for your specific case.
Chin surgery is an essential part of orthognathic surgery, and should be considered in every treatment planning. If their is a need or a feeling for, then the choice of the right surgical strategy is the next step. A chin can be made wider or smaller and can be placed forwards or backwards. The chin can be set back, lengthened, or shortened. The chin can be spatially rotated or translated or shaved and remodelled. Or the choice can be made to enhance the area not with an osteotomy/=genioplastie but in in a implant material PEEK. This should then be worked and completely designed and prepared before on the computer.
Facial Sculpture Clinic - Dr Joël Defrancq - Jaw surgery and implant reconstructive surgeryFacial Sculpture Clinic - Dr Joël Defrancq - Jaw surgery and implant reconstructive surgeryFacial Sculpture Clinic - Dr Joël Defrancq - Jaw surgery and implant reconstructive surgery
The surgical access is an intra-oral incision behind the lower lip. This incision line is barely noticeable after one week and heals extremely well. The bone is cut in the appropriate zone, well underneath the exit of the sensibility nerve of the lip (mental nerve), and well underneath the root tips. This is done with a reciprocating saw. The chin point is relocated, whilst artificial bone grafts and a membrane can eventually be added when indicated. The chin bone is fixed with two titanium screws and/or a specific chin mini-plate. The muscles are reattached with resorbable PDS sutures and the overlaying tissues are closed. After surgery, a steri-strip dressing is applied to the chin for some days. This is to settle the chin muscles firmly to the bone. The surgery takes 45-60 minutes and is usually carried out with upper or lower jaw surgery or as a separate operation. The chin operation is always carried out under general anaesthesia.
Postoperative instructions & frequently asked questions

Is a silicone implant or medpor implant an alternative method?

Some surgeons are indeed using silicone or medpor, and often the implant is inserted through a sub-mental skin incision. Maxillofacial surgeons usually don’t use implants or a sub-mental skin incision. Silicone After being in place for years, silicone often gets pushed deep into the bone, sometimes ½ to 1cm. This is caused by the pressure of the muscles overlaying the implant, melting away the chin bone over time. Dr Defrancq has removed several of those and replaced them with a proper genioplasty advancement.

Are nerve disturbances an issue?

There can be some temporary sensibility alterations to the lower lip, as there is with lower jaw surgery (BSSO). Normally, this fades away after some time.