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Study Examines Combo Chin, Nose Plastic Surgery
Date:3/15/2013

in JAMA Facial Plastic Surgery, Bertossi's group followed 90 people who had their noses and chins reshaped simultaneously between January 2002 and January 2004.

Over three years of follow-up, the researchers found that almost half (45.6 percent) of those who had their chin reduced had no subsequent changes in the new chin.

For those who had chin extensions, 52 percent had a "stable" profile three years later, meaning no more than a millimeter of change, the researchers noted.

Salomon pointed out that each of these surgeries does carry some element of risk.

Nose surgery may be more problematic than chin surgery. "It is decidedly harder to get good rhinoplasty results compared with genioplasty," Salomon said. Also, all nose jobs subtly change over the first 12 to 24 months, he added.

"Complications of rhinoplasties are not uncommon," Salomon said. "There are some surgeons known to be the 'go-to surgeons' for secondary or tertiary nose-job revisions, and those surgeons get their referrals from other surgeons who had bad results."

For chins, "most competent surgeons can get terrific genioplasty results either by cutting and sliding the existing chin forward or by using an off-the-shelf chin implant," he said.

Enhancing the chin by cutting the bone and sliding it into a new, more advanced position is more invasive and more costly compared with just inserting a chin implant, and the recovery is longer, Salomon said.

There is also more risk for complications, including nerve damage, and the screws and plates used to stabilize the bone as it heals can damage tooth roots, he explained.

"If the bone doesn't heal, a secondary procedure may be required," Salomon said.

Even chin implants, which he termed "convenient," can erode into the underlying bone. "The erosion can be significant enough to result in loss of previous advancement. Therefore, the results of a bony genioplasty have more stable long-term result
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