Combined rhinoplasty and genioplasty: Long-term follow-up

Importance: Long-term follow-up reference for experiencedclinicians dedicated to profileplasty.Objective: To evaluate the long-term results and complicationsof combined rhinoplasty and genioplasty.Design: Retrospective study including objective and subjectiveevaluation before and after 3 years of undergoingsimultaneous open rhinoplasty and genioplasty amonga cohort of 90 patients.Setting: Academic medical center.Patients: A total of 90 cases of combined rhinoplastyand genioplasty performed from January 2002 throughJanuary 2004 were reviewed to evaluate the stability ofthe esthetic result.Main Outcome Measure: Long-term stability of theesthetic outcome of the simultaneous open rhinoplastyand genioplasty.Results: Soft-tissue Pogonion projection to the true verticalline and mandibular height (mandibular incisor tipto menton) were recorded. As far as reduction genioplastypatients are concerned, 45.6% of the patient populationhad a 100% stability after 3 years (0.25 mm resorptionmeasured at the menton). On the other hand,if augmentation genioplasty patients are considered, 52.4%(22 patients with a vertical augmentation range from 4-6mm; mean, 5.3 mm; and 25 patients with a sagittal augmentationfrom 6-8 mm; mean, 7.2 mm) had 100% stabilityafter 3 years. The chin was stable with no more than1 mm of recurrence.Conclusions and Relevance: The results of the studyindicate that the combined approach in correcting thefacial profile is an effective procedure to achieve a moreharmonic and consistent clinical outcome. The recurrencerate of less than 1 mm on the chin bone measurementsis relevant to support this statement. An aestheticallyproportionate face is strongly determined by thenasal-cervical relationship when observing the patient’sprofile. Even after a successful rhinoplasty, the patient’sface can lack aesthetic attractiveness. Combined rhinoplasty-genioplastyis usually the best solution, particularlyfor patients with microgenia. It provides optimumpatient satisfaction with a low incidence of recurrence.