High labial incisions for genioplasty.

Clinical experience in genioplasty has shown that high labial incisions heal with fewer scar bands than conventional deep labial incisions. In a prospective randomized trial, we compared 18 high labial curvilinear incisions with 27 high labial W-shaped ('royal') incisions for access and visibility during chin osteotomy. Both incisions were 3 cm wide. Maximal incision lengthening between two skin hooks was recorded with a ruler before closure, and there was no significant difference between the two. The maximum wound area between three skin hooks was photographed and computed, and showed a mean difference of 188.75 mm2 (t-test, P < 0.001), which corroborated the clinical findings that access and visibility were superior in the W-shaped incision group. Complications were few in both groups. We now use the high labial royal incision about 3.5 cm wide, with 90 degrees limb angle for complicated chin osteotomies and ostectomies. A smaller curvilinear high labial incision is used for simple advancement osteotomies.