Nikolas R Block-Wheeler, MD MS
Andrew Kleinberger, MD
Kathleyn Brandstetter, MD
Justina Bell, PA-C
Charles Shih, MD
Kaiser Permanente, East Bay, Department of Head and Neck Surgery, Oakland, CA;
Background: Feminizing genioplasty is commonly performed to narrow and/or shorten the chin. Little is known how the procedure affects the projection of the overlying soft tissue.
Learning Objective: To understand the role feminizing genioplasty can have on soft-tissue chin projection. Study
Objective: To characterize the effect of feminizing genioplasty on chin projection. Design Type: A retrospective case series and cohort design.
Method: Adults undergoing feminizing genioplasty were identified at a single institution from 2018 to 2022. Pogonion projection was measured as the angle formed by the Frankfurt horizontal line and a vector intersecting the pogonion and labiomental sulcus. The measurement was obtained pre- and post-operatively. Univariate analyses were use to test the effect of the procedure, as well as the addition of a chin-pad binding suture.
Results: A total of 22 patients were included. Eleven of these had a chin-pad binding suture performed in addition to the feminizing genioplasty. On average, patients gained 9.4 degrees (SD 9.4) from the feminizing genioplasty alone (p<0.01). The addition of a chin-pad binding suture provided additional projection (M=11.6 degrees, SD=9.2); this was not significant compared to the feminizing genioplasty alone.
Conclusions: Narrowing and/or shortening the bony chin results in greater soft tissue projection at the pogonion. The genioplasty with soft-tissue binding suture improves projection while narrowing the soft tissue pad. Understanding the effect of feminizing genioplasty on chin projection can help surgeons utilize it to their advantage.