Step Genioplasty Using Trapezoid Osteotomy for Chin Advancement.

[BACKGROUND] The chin-the most prominent feature of the lower face-greatly affects overall facial attractiveness and harmony. Among some East Asian women, a broad, square chin is considered aesthetically unpleasing, whereas a small and slightly protruded chin is deemed attractive. For these patients, advancement and narrowing genioplasty may be indicated. The authors present step genioplasty using trapezoid osteotomy procedures and evaluate the outcomes.

[METHODS] A retrospective review of consecutive patients who underwent genioplasty between January of 2019 and December of 2023 was conducted. Lateral cephalograms were obtained and measured to assess changes in facial profile.

[RESULTS] A total of 145 patients underwent step genioplasty using trapezoid osteotomy, with a mean age of 31.0 ± 7.9 years at the time of operation. The mean follow-up period was 17.4 ± 12.8 months postoperatively. The average chin advancement and shortening were 5.3 ± 2.0 mm and 3.4 ± 1.4 mm, respectively. No major postoperative complications were observed. Cephalometric analysis revealed the efficacy of genioplasty in chin advancement, with a mean soft-to-hard tissue ratio of 0.90:1 and minimal bony relapse rate of 3.0%.

[CONCLUSIONS] The trapezoid-shaped osteotomy allows for chin narrowing and the bony step serves as a stabilizer, facilitating long-term bony stability and sufficient soft-tissue response. Step genioplasty using trapezoid osteotomy can be a viable option for patients with a broad and recessed chin.