Combined mandibular angle osteotomy and wing-shaped genioplasty for the correction of low-angle mandibular prominence and microgenia
10.3760/cma.j.cn114453-20250115-00014
- VernacularTitle:下颌角截骨联合颏部翼状截骨成形术矫正低角型下颌角伴小颏畸形的临床效果
- Author:
Ning LIU
1
;
Huili WANG
1
;
Shuang CHEN
1
;
Xiaodong NI
1
;
Yufeng LIU
1
Author Information
1. 南京中医药大学附属南京医院 南京市第二医院整形外科，南京 210003
- Publication Type:Journal Article
- Keywords:
Osteotomy;
Genioplasty;
Mandibular angle osteotomy;
Wing-shaped genioplasty;
Low-angle mandibular prominence;
Microgenia
- From:
Chinese Journal of Plastic Surgery
2025;41(11):1167-1174
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical outcomes of mandibular angle osteotomy combined with wing-shaped genioplasty for the correction of low-angle mandibular prominence with microgenia.Methods:A retrospective analysis was conducted on patients who underwent mandibular angle osteotomy and wing-shaped genioplasty at the Second Hospital of Nanjing between January 2020 and December 2022. Preoperative three-dimensional computed tomography and lateral cephalograms were obtained, and relevant parameters were measured, including the Frankfort horizontal plane to mandibular plane angle (∠FH-MP), the lower lip to soft tissue pogonion angle (∠LiaV-Pog) and the facial height index (FHI). Based on the measurements, surgical experience, and patient preference, the osteotomy lines for the mandibular angle and the wing-shaped genioplasty were designed. During the procedure, mandibular angle osteotomy and wing-shaped genioplasty were performed in accordance with the preoperative surgical plan. The distal genial segment was advanced and inferiorly repositioned according to the predetermined measurements and rigidly fixed to the bilateral mental tubercles using titanium plates and screws. The bone segments resected from the mandibular angle were then longitudinally split into either single- or double-layer bone grafts. These grafts were meticulously implanted into the interpositional gap at the genial region to optimize chin projection and refine the lower facial contour. Postoperative monitoring included assessments of wound healing, complications and lower facial contour. At the final follow-up, lateral cephalograms were taken for remeasurement, and patient satisfaction was surveyed. Statistical analysis was performed using SPSS 22.0 software. Pre- and postoperative data for ∠FH-MP, ∠LiaV-Pog, and FHI were presented as Mean ± SD and compared using paired t-tests, with a P-value < 0.05 considered statistically significant. Results:Twelve female patients, aged 22-35 years (mean 28.3), were included. The follow-up period ranged from 6 to 24 months. All surgical sites achieved primary healing without early complications such as hemorrhage, hematoma, or wound infection. However, all patients experienced transient mental numbness, which resolved within 3 to 6 months. All patients achieved a smooth and natural mandibular contour. CT scans confirmed satisfactory survival of the grafted bone. All patients expressed satisfaction with the aesthetic outcomes. Postoperative measurements of ∠FH-MP, ∠LiaV-Pog, and FHI were (25.2±4.6)°, (24.0±1.2)°, and (52.0±1.3)%, respectively, which were significantly improved compared to the preoperative values of (16.8±5.9)°, (36.5±4.8)°, and (66.0±4.3)% (all P < 0.01). Conclusion:The combination of mandibular angle osteotomy and wing-shaped genioplasty is an effective and safe procedure for correcting low-angle mandibular prominence with microgenia. This technique significantly increases the mandibular plane angle, creates a natural and smooth mandibular contour, and yields stable result with high patient satisfaction.
