A correct projection of the chin is an important element of beauty in the profile and in the harmony of the face. The alterations can be in defect or in excess, determining respectively a small and elusive chin or a prominent chin. The plastic surgeon must be ready to analyze the profile and be able to detect the presence of these imperfections. Sometimes there is an alteration in the occlusion of the dental arch, which may also involve orthodontic treatment or orthognathic maxillofacial surgery. Often the alteration of the chin is associated with a nasal deformity and, in these cases, rhinoplasty without mentoplasty alone is not able to restore the right harmony and beauty to the face. Additive mentoplasty can be easily performed by inserting an appropriately sized silicone prosthesis into a pocket in front of the chin bone. A small incision in the mucosa of the lower gingival fornix, below the incisors, is sufficient for the introduction of the prosthesis, without any visible external scar. Reductive mentoplasty involves the progressive removal of bone tissue until the desired chin projection is achieved. In more severe cases, the chin section, the removal of an internal bone block and subsequent osteosynthesis of the chin to the meandibular region behind with titanium plates may be indicated.
This patient came to the visit complaining of an overall aesthetic alteration of her profile.
The clinical analysis showed a prominence of the nasal back, a particularly drooping tip and little projected into space, a small and elusive chin. The surgery performed a harmonization of the profile by removing the small hump, remodeling and upward rotation of the tip, mentoplasty. The result shows a pleasant harmonization of the profile.
RHINOPLASTY, MAXILLARY ADVANCEMENT, REDUCTIVE MENTOPLASTY
This patient complained of an altered profile due to the presence of a conspicuous nasal hump, prominence of the chin and altered occlusion of the dental arches.
The clinical analysis showed: nasal back hump, dental malocclusion with bite reversal, chin hyperplasia. The surgery, performed in a single time, involved: rhinoplasty with removal of the nasal back hump and remodelling of the tip; orthognathic surgery with advancement of the upper jaw; reductive mentoplasty with removal of a mandibular bone dowel. An orthodontic therapy preparatory to the operation was also performed to adapt the dental arches to their new position obtained after surgery.