Genioplasty with piezosurgery

Aims: The chin is the most prominent and median sector of the lower third of the face giving harmony to nose and lips. We present the application of piezoelectric bone cutting device for the correction of different chin deformities. The distinctive characteristics of this device allows us to avoid or reduce the immediate genioplasty complications. Methods: 25 cases of defective chin have been treated from January 2006 to April 2007. Intraoral chinplasty was performed during the correction of dentofacial dysmorphisms or associated to nasal surgery. We used a piezoelectric cutting device to perform different osteotomies and if necessary, different kind of interpositional grafts were used to stabilize bony segments. Results: We observed a more precise and thin osteotomies (100% of cases), a reduced intraoperative bleeding (92%) with light degree of postoperative hematoma, no nervous injuries (100%, slight paresthesia 36%) and patients’ satisfaction (96%). Discussion: Chinplasty represent one of the most common ancillary procedures and may be associated with corrective surgery of skeletal bases in dentofacial dysmorphisms. Mental nerve injuries, asymmetries, intraoperative bleeding are the main immediate complications of genioplasty. Distinctive characteristics of ultrasonic piezoelectric osteotomy are selective cutting of only mineralized structure with less risk of vascular and nervous damage (microvibrations), intraoperative precision (thin cutting scalpel and no macrovibrations), blood free site (cavitation effect). In our experience, piezoelectric cutting device, compared to saw and drill, enables us to reduce or avoid immediate complications of chin surgery, helping the surgeon to reach patients’ satisfaction