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4 Color Fig(s): F1-8

Art: PRS-D-20-02790

COSMETICA New Concept of Narrowing Genioplasty:
Home Plate–Shaped Sliding Osteotomy
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Toshitsugu Hirohi, M.D.
Tokyo, Japan

Background: Narrowing genioplasty is commonly performed among East Asian
populations, as a broad and/or square chin can be aesthetically unappealing.
This study was aimed to introduce the home plate–shaped sliding osteotomy
technique for narrowing genioplasty and to evaluate the results of this technique.
Methods: A retrospective chart review of 117 patients who underwent homeplate–shaped sliding osteotomy alone between 2011 and 2019 was performed.
The angles of oblique osteotomy lines and measurements of caudal repositioning, which significantly affect the postoperative chin shape, were evaluated.
Results: The home plate–shaped sliding osteotomy technique was successfully accomplished for narrowing genioplasty as an isolated procedure. The
mean distance of caudal repositioning was 3.9 ± 0.8 mm, and the mean anglesof oblique osteotomy lines were 23.3 ± 4.8 degrees on the right and 21.8 ±3.5 degrees on the left. This produced an aesthetically pleasing rounded andproportionately narrow chin. The incidence of minor complications was 6.0percent. There were no major complications. In particular, the risk of inferior
alveolar nerve injury was obviated, as an additional mandibular border osteotomy was not typically used with this technique.
Conclusions: This new surgical procedure for narrowing genioplasty provides
improved aesthetic results by altering the chin shape, rather than reducing
the transverse width of the chin. The versatility of this procedure allows thechin shape to be adjusted with respect to narrowing, vertical lengthening,
anterior advancement, and asymmetric or cleft chin correction. The present
study suggests that home plate–shaped sliding genioplasty may be an excellent
alternative for correcting broad and/or square chins and more complex chin
deformities. (Plast. Reconstr. Surg. 148: 00, 2021.)
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

T

he chin is one of the most noticeable facial
structures and is thus frequently targeted
for aesthetic facial bone-contouring surgery. The concept of an ideal facial shape varies
among ethnic groups. In East Asia, for example, arounded chin is considered to be the most desirable shape.1–3 This is in contrast to a broad andsquare chin, which may be aesthetically unpleasing among East Asian women. Therefore, narrowing genioplasty is widely performed as a V-line
mandibular contouring procedure among East
Asian populations as an aesthetic operation.
Multiple approaches for narrowing genioplasty have been described to correct broad or
square chins.4–16 First, the T-shaped osteotomy
method has been the most widely performed forFrom the Ritz Cosmetic Surgery Clinic.
Received for publication July 30, 2020; accepted December
18, 2020.
Copyright © 2021 by the American Society of Plastic Surgeons
DOI: 10.1097/PRS.0000000000008187

narrowing genioplasty.6,12,14,16,17 This procedure
involves central bone segment resection with horizontal and two vertical osteotomies followed byreapproximation of the bone fragments of eachside. The mean width of the central bone segment
has been reported to be 9.1 mm.16 However, theprocedure occasionally produced an insufficientnarrowing effect for patients with broad and/or square chins.8 Nevertheless, further resection
may cause many problematic sequelae. Second,the “oblique mandibular chin-body osteotomy”
or “one-piece osteotomy” is a simple and popular procedure commonly used as well.5,7,15 The
Disclosure: The authors have no financial interest
to declare in relation to the content of this article.

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