Optimizing Esthetic Outcomes and Bone Stability: Chin Advancement Through Inverted V Osteotomy

J Craniofac Surg. 2024 May 13. doi: 10.1097/SCS.0000000000010259. Online ahead of print.

Abstract

Traditional horizontal osteotomies for small and short chins often yield suboptimal results due to limited bone advancement, resulting in deep labiomental folds and heightened bone resorption risks. This study investigates the effectiveness of an innovative inverted V-shaped osteotomy technique in enhancing esthetic outcomes for patients with such chin concerns. Thirty-eight patients who underwent inverted V-shaped osteotomy for recessed chins between January 2018 and June 2022 were included. Excluding cases involving simultaneous mandibular contouring surgery, patients were followed up for a median duration of 1.2±0.5 years. Preoperation and postoperation soft tissue pogonion (Pg') and labiomental fold depth (LMF) changes were measured. IBM SPSS (version 27.0) was used for statistical analysis, with significance defined as P<0.05. Patient satisfaction was assessed using a visual analog scale. Successful advancement genioplasty was performed on all patients without any severe complications. The average change in soft tissue pogonion (Pg') measured 6.2 (1.9) mm, and the mean alteration in labiomental depth was 0.42 (0.4) mm. The procedure achieved a bone to soft tissue movement ratio of 1:0.96. Patient satisfaction was notably high, with a mean VAS score of 8.7. An inverted V-shaped osteotomy enables greater bone advancement for small and short chins, leading to improved esthetic outcomes and offering a mechanically advantageous condition for bone segments.