Satisfaction with Chin Surgery
Q: I would like to know what the rate of satisfaction is amongst patients that have had chin osteotomies or chin implants when actually they should have had lower advancement jaw surgery? Are they happy with their appearance or do they feel their top teeth extend out too much when they smile?
A: The short answer is yes. But that answer needs a more detailed explanation. The key is proper patient selection and understanding that a chin implant or osteotomy for a mandibular deficient patient is a compromise operation. It is treating the symptoms of the problem and not the primary problem. In other words, one is camouflaging the real defect and accepting whatever (if any) functional problems that may exist.
The idea treatment for a mandibular deficient patient with a malocclusion (Class bite relationship where the lower teeth are behind the upper…an overbite) is orthognathic surgery. Specifically, a mandibular advancement osteotomy with preparatory and postoperative orthodontics. While this is a very effective operation, it requires a commitment of several years of orthodontics, an operation, and the risks of damage to the inferior alveolar nerve. (some permanent change in the feeling of the lip and chin) The decision for mandibular advancement surgery, therefore, should be based on one’s age and the degree of malocclusion. You must balance the risks vs the benefits like any surgery. If one is young with more than several millimeters of overbite, this should seriously be considered and even done. In patients who are older, often with even more significant overbites, the enthusiasm for this surgical effort is often not there. Camouflaging the jaw defect and getting a better profile and improved facial proportions through a simpler chin implant or osteotomy has a lot more appeal.
In my Indianapolis plastic surgery experience, I have never had any unhappiness amongst patients who has chosen the isolated chin route. Nor has it been reported to me that their upper teeth stick out too far when they smile.
Dr. Barry Eppley