Can The Fixation Plates In Sliding Genioplasty Be Felt Externally?

Q: Dr. Eppley, I have a couple of questions regarding genioplasty and osteosynthesis plates:

1. If you have a lean face, would you be able to feel the osteosynthesis plate when touching your chin bone (i.e., when shaving or when scratching the chin bone)?

2. Can you feel the genioplasty osteotomies’ cuts/lines when touching your chin bone?

3. If I want to remove the osteosynthesis plate after the genioplasty. What would be the ideal time window? Is plate removal a straightforward procedure with low downtime?

4. It seems like they are different models of osteosynthesis plates. In the illustration of the procedure, one can see an X-like design placed in the middle of the chin bone; others are like small bars placed on the right and left of the chin bone. Is there any particular indication to use a specific model of osteosynthesis plate, or is this based on the surgeon’s preferences?

Thank you,

A: In answer to your bony genioplasty questions:

1) Hardware palpation is an uncommon occurrence given the thickness of the soft tissue chin pad even in lean faces.

2) In some patients the back end of the osteotomy lines (step offs) may be palpable. This is more evident in larger bony genioplasty movements.

3) Hardware removal can be done as early as 3 months after the original procedure when the bone is adequately healed. As you have surmised hardware removal is associated with a reduced surgery and recovery time.

4) There are numerous methods of genioplasty fixation, all of which can be effective when properly used Thus the method of fixation used is largely surgeon dependent. In larger and unique bony movements one method of fixation may be more effective than others.

Dr. Barry Eppley

World-Renowned Plastic Surgeon