[Long-term results after genioplasty].

The serial records of 21 patients were analyzed to study the stability of genioplasty performed in the course of orthognatic surgery and to describe its effect on the soft tissue profile. A pre-operative and a post-operative cephalogram as well as a cephalogram one year after surgery of each patient were available. Sagital correction of the chin from 16.5 mm advancement to 1.1 mm reduction and vertical movements between 4.8 mm lengthening and 9.3 mm shortening remained nearly unchanged during the control period. No post-operative movements of the chin fragment were observed except for minor resorptions that can be attributed to an osseous remodelling and rounding of sharp edges. In cases of a long face syndrome a bone apposition from 1 mm to 5.5 mm appeared at the lower edge of the chin. The average of sagittal soft tissue change in relation to the correction of the bony chin was 71%. The individual values ranged from 4% to 145% and the standard error of the estimate was 3 mm. Therefore the planning of the soft tissue profile is rather unreliable. A genioplasty performed with rigid fixation by compression screws or mini plates, preservation of vascular supply and re-fixation of the soft tissue of the chin results in accurately predictable and stable bony contours. On the other hand, the planning of surgery procedures related to the soft tissue profile is--if at all possible--very insecure.