Splitting advancement genioplasty: a new genioplasty technique.

A new genioplasty technique has been described and performed on 16 patients since 1995. The technique has been developed to avoid some undesired results of the current osseous genioplasty techniques and to achieve a more natural appearance in advancement genioplasty. According to the authors' technique, a rectangular part of the outer table of the mentum is split away from the mandible, and is advanced and fixated to the mandible. This technique can be used for advancement cases but not for reduction genioplasty. This technique was performed on 16 patients with only minor complications, including one case of wound dehiscence, one hematoma, and one case of osteomyelitis, which was managed with systemic antibiotic therapy. Aesthetic results were found to be satisfactory according to an evaluation by the authors. When the results were evaluated using pre- and postoperative photos, lip position and projection of the mentum were found to be natural in shape appearance. During the late postoperative period, the new bone formation between the advanced segment and the mandible was demonstrated radiographically. Advantages of the technique include having more contact surfaces for bony healing, a natural position of the lower lip, more natural projection of the mentum, tridimensional movement of the mentum, and improvement in the soft tissue of the neck. The disadvantages of the technique are the potential risk of infection due to dead space from the advancement, manipulation problems during surgery, and possible mental nerve injury. Splitting advancement genioplasty was found to be a useful technique for advancement genioplasty. Splitting advancement genioplasty is a more physiological osteotomy technique than most of osseous genioplasty techniques.