How & where does bone resorption happen after sliding genioplasty?

Question

Hello, I am planning on getting a sliding genioplasty surgery done, but I have read several studies online noting a millimeter or two of bone resorption after the procedure. How and where does this resorption happen? And can it be prevented or minimized with a good diet?

Michael P. Morrissette, DDS, FACS · Answer

I am not of bone resorption in association with a sliding genioplasty. With chin implant surgery, there is a degree of settling that can occur with 1-2 mm of bone resorption. This can be minimized with the placement of bone screws. Following a sliding genioplasty, there will be bone remodeling at the osteotomy site which is part of the normal bone healing process. I would not expect any resorption of the cortical bone.

Zoran Potparic, MD · Answer

It is not likely that you will develop any significant bone resorption after genioplasty or implant augmentation. Bone resorption can be occasionally observed on the x-rays but it is not clinically visible. You should discuss this issue with your surgeon before surgery as well. Good luck.

Alejandro Nogueira, MD · Answer

There is no one mm of bone resorption after a sliding genioplasty, unless a major and rare complication occurs in the form of steomyelitis or osteonecrosis (the latter normally due to technical error).

It is true the power saw, like whan you cut wood, chips away maybe 1 mm of matter at the same time it cuts through, but that's totally negligible.

Guray Yesiladali, MD, FEBOPRAS · Answer

Thank you for your thoughtful question&mdash;it's great that you're researching this in detail before your procedure.
Sliding genioplasty involves cutting and repositioning the lower portion of the chin bone (genial segment) to improve projection, shape, or symmetry. The repositioned bone is then stabilized with plates and screws in its new location.
Bone resorption, when it occurs, typically affects the edge of the advanced bone segment&mdash;especially areas that are no longer under mechanical stress or lack full vascular support. In most cases, this resorption is minimal&mdash;usually 1–2 mm&mdash;and clinically insignificant. It does not typically compromise the overall result.
There are a few things that can help minimize this process:
Precise surgical technique with good contact between bone surfaces
Stable fixation with well-positioned plates and screws
Healthy post-op healing supported by adequate nutrition (calcium, vitamin D, and protein)
Avoiding tobacco and chronic inflammation, both of which can impair bone remodeling
It's worth noting that bone resorption is a natural part of how the body adapts to changes in structure. Most patients do not even notice it&mdash;especially when the movement is moderate and the procedure is well-executed.
Wishing you confidence and clarity as you move forward,Op. Dr. Güray YeşiladalıBoard-Certified Plastic Surgeon

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Ply 191057,

Thank you for your question. Interesting that you found that there's 1 to 2 mm of absorption after sliding a sliding genioplasty.  After nearly 30 years of providing this procedure, I have not  run into the literature concerning that issue nor have I seen that affect the clinical outcomes in my clients. I'm sure there are a couple of milliliters of remodeling but resorption insinuates that this is a destructive type of pattern that can affect outcome. Sliding genioplasty performed expertly for the right client can be a powerful procedure. Clients are ecstatic in my experience after the dramatic changes they see with the procedure.

Best of luck.

ESJ

#TruthAndTransformation

Jeffrey H. Spiegel, MD · Answer

Genioplasty is where the chin area of the jaw is cut and the bone moved around. This bone is then secured in position with a metal implant and screws.  You lose bone in the cut, and likely around the edges of the cut. Plus, there is a chance that the bone doesn't heal.  Some people prefer genioplasty because they think it is more natural than a chin implant, but, there is metal placed so there are already foreign materials there.

Without your picture it's hard to see what's happening, but, a chin implant could possibly be done quicker, more safely, and more easily with the same results. Plus, a chin implant is reversible.  Now, yes, some people will say that a chin implant can result in some bone absorption.  But, this has never, in my 25 year experience, been a clinically significant problem.  A chin implant can also be done right in the office and then you go right home.

Mats Hagstrom, MD (license on probation) · Answer

Bone is dynamic and continues to remodel throughout our life.
A childhood fracture that was never reduced, can straighten out overtime. Likewise after surgical intervention bone structure can change. Women who get breast implants can get in dented ribs, etc. etc.
A change in chronic pressure on bone can make it remodel in certain ways, when bone is cut, the loose fragment loses its primary blood supply.All of these variables contributed to bine remodeling and surgeons will take this into consideration as is appropriate, depending on what the procedure is being done.
There is nothing patient can do to alter bone remodeling after a sliding genioplasty.
Best,
Mats Hagstrom, MD

How & where does bone resorption happen after sliding genioplasty?

Answers (7)

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