the génioplastie allows to change the position of the chin and the lower lip to which it relates in relation to the lower jaw and the remainder of the face. A lower lip incorrectly positioned relative to the teeth may cause constraints on them and move in the same way as orthodontics that by gentle and continuous forces moves the teeth. This is why as part of orthognathic surgery genioplasty is envisaged and realized for functional reasons although its aesthetic impact is significant.
Outcome of surgery
This procedure is performed under general anesthesia. Excluding intraoperative complication there is no skin scar, since the entirety of surgical approaches is made in the mouth.
After incising the mucosa behind the lower lip, the chin bone is cut by protecting the lower alveolar nerves that are responsible for the sensitivity of the lip and that pass close. The movable portion of the chin is positioned in the cephalometric analysis of the patient and then fixed using a mini plate and miniscrews.
The surgical approach is sutured with absorbable son and compressive bands are set up at the chin to reduce the risk of hematoma.
The facial appearance is thereby necessarily changed and we must have realized before considering this type of intervention.
The mini plates is invisible after the procedure since it is in contact with the bone and covered by mucous. It allows to stabilize the displaced bone fragment in the desired position. However it is not as strong as the natural bone and therefore it is desirable not to force it as the bone has healed. A lack of activity a risk of trauma to the jaw during 3 months are required after surgery.
usual postoperative and post-operative care
This type of surgery usually requires hospitalization rule 2 days.
Swelling of the face can be very important, it is maximal at 48 hours of the intervention and gradually fades in 2 weeks. Why a downtime and work stoppage during this period are advised.
The pain in the operated areas often gives with analgesics and disappears in a few days.
ice packs coated with a cloth (not directly on the skin) decrease swelling and pain.
Often small bleeding persists for a few days & rsquo; Intervention. The treatment consists of mouthwash in ice water.
Despite all the attention paid to it the inferior alveolar nerve mentioned above is very often traumatized during surgery which is not reflected by pain but by insensitivity of the territories that are under its control. The sensitivity returns spontaneously within weeks.
The son of sutures are absorbable and fall alone from 15 days. A very soft surgical toothbrush is required to clean and avoid becoming irritating due to the presence of plaque.
Good oral hygiene is essential for the healing is done without complication. After each meal, teeth and gums should be cleaned by brushing. mouthwash are prescribed in addition to brushing.
Food should not be hard for the 6 weeks after surgery otherwise bend or loosen mini plates. Besides eating hard foods on surgical approaches is painful and promotes infections. Specifically: During the 2 first days, the diet should be soft, warm or cold. Then during the 12 days Avoid very salty or very acidic foods. Also avoid offensive foods: biscuits, toast, chips ... Also avoid very small items that could come between the dots and create infections semolina, peanuts, rice, peas ... And finally continue for 4 weeks with a soft diet for a total ensure the healing bone ongoing lack of food trauma 6 weeks. You will find on the site https://docteurwajszczak.fr/conseils/ recipe ideas suited to you after this type of surgery.
Tobacco is avoided in the aftermath of the intervention, it decreases the mucosa and bone healing, promotes infection and increases the post operative pain. Alcohol is not compatible with the medications prescribed after surgery and is also prohibited.
The mini mini plate and screws implanted to stabilize the bone fragments can be palpable and become annoying. This is why it is advisable to remove once the bone healed (between 6 months 1 an). This procedure is done under general anesthesia but also it is an act much lighter than that caused their poses and performed most often in outpatient.
Several consultations checks are carried out in the aftermath of the intervention by both the maxillofacial surgeon. They help ensure the proper development of postoperative.
Post-operative orders are given most of the time before surgery. This will fetch the post operative medication before surgery and have it available directly on the day of the release of the clinic.
The compressive bands are removed to 48 hours of intervention.
Risks and Complications
Any medical procedure, very well led, harbors a risk of complications. Do not hesitate to contact the surgical team that took care of you, or clinical emergencies or contact 15 in case of serious emergency.
There may be rare complications:
The stitches all fall alone and mucous general rule is already healed. But if they fall prematurely or if the lining does not heal the surgical approach may reopen. If this disunity points causes a small opening it heal spontaneously but the take some time. However if disunity is important it will be necessary to put points.
An infection of the soft tissues of the cheek (cellulitis) can occur days or even 2 at 3 weeks after surgery. It is consecutive to the stagnation of food residue in the surgical. It gives a suitable antibiotic treatment, exceptionally it may be necessary to carry out surgery to drain an abscess if cellulite is complicated.
If there is a fragility of temporomandibular joint intervention can decompensate it and cause a limited mouth opening, pains, and joint crunches. In the vast majority of cases everything is in order in a few weeks.
Or exceptional complications:
A hematoma can occur in the operating suites. If it is small it will resolve spontaneously, however it is important it will be necessary to evacuate surgically. The rare but serious complication remains hematoma floor of the mouth, it can force the tongue back and obstruct the airway, must be evacuated in emergency.
The alveolar nerve can be injured or cut significantly during the intervention. This can cause a definite anesthesia halves of the dental arch, of the lower lip and chin corresponding thereto. Moreover this same nerve in cases of significant injury can heal a painful fashion. Even more uncommon motor nerves of the lower lip can be traumatized and cause paralysis of it temporary or permanent anecdotally.
Delay or absence of bone healing: very rare, it requires to carry out a new operation with sometimes bone grafting.
Trauma occurring on the mini plate while the bone is not well healed may twist, unseal or break. It is then necessary to replace this plate and this is done under general anesthesia.
In total, should not overstate the risks, but just be aware that surgery, even seemingly simple, still a small share of hazards.
It is very important to bring the day of the procedure: the plaster study models, All radiographs: dental panoramic, teleradiographs craniofacial front and profile and the scanner if it had been prescribed a. Without these intervention can not be performed.