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Perfect example of a multidimensional genioplasty in the form of two dimensional augmentation genioplasty in a patient with a slightly receded chin in the depth axis and also featured by a moderately short vertical chin axis in the context of an overall small chin; horizontal width was deemed optimal thus a three dimensional genioplasty was not indicated.

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Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 1
#1Moderate shortfall of vertical height of the chin; its correction requires the insertion of a very carefully tailored bone graft perfectly matching so that the desired vertical height is achieved; the arrows indicate the grade of increase of ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 2
#2Slightly receded and moderately short vertically chin in need of a medium augmentation by means of an oblique osteotomy at approximately 70 degrees from the bisecting plane of the chin so that 70% of the increase produce vertical gain and 30% ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 3
#3Lateral cephalometrics and planning on X ray film. The desired level and angle for the osteotomy are drawn as a guidance tool for the surgeon. The arrow points at the foramen or exit duct for the mentalis nerves, a critical structure that has ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 4
#4Customized bone graft harvested from patient's elbow; note how the end to be placed at patient's right side of the chin has larger thickness than the end to be placed at patient's left side of the chin, designed in a progressive thickness increase ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 5
#5Customized bone graft harvested from patient's elbow; note how the end to be placed at patient's right side of the chin has larger thickness than the end to be placed at patient's left side of the chin, designed in a progressive thickness increase ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 6
#6Customized bone graft harvested from patient's elbow and held by the forceps as size reference; note how the end to be placed at patient's right side of the chin has larger thickness than the end to be placed at patient's left side of the chin, ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 7
#7Customized graft harvested from patient's elbow.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 8
#8Customized bone graft harvested from patient's elbow and held by the forceps as size reference; note how the end to be placed at patient's right side of the chin has larger thickness than the end to be placed at patient's left side of the chin, ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 9
#9Customized graft harvested from patient's elbow; note the beveled medial ends designed to meet in the midline fitting the boomerang shape of the chin.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 10
#10Customized graft harvested from patient's elbow; note the beveled medial ends designed to meet in the midline fitting the boomerang shape of the chin; the forceps acts as size reference.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 11
#11Customized graft harvested from patient's elbow; note the beveled medial ends designed to meet in the midline fitting the boomerang shape of the chin.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 12
#12Customized graft harvested from patient's elbow; note the beveled medial ends designed to meet in the midline fitting the boomerang shape of the chin.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 13
#13Wiring of the assembly; the multidimensional genioplasty involves wiring, via holes drilled in the bone, the anterior cortex of the mandibular bone with the anterior cortex of the sliced chin fragment so that a stronger stabilization effect ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 14
#14Prismatic scheme of the mandibular bone, the customized graft and the sliced chin fragment.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 15
#15The lines contour the fixation steel wires and the drilled holes to allow the assembly; at this stage all the elements were wired and ready to be secured.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 16
#16Wiring of the assembly; the multidimensional genioplasty involves wiring, via holes drilled in the bone, the anterior cortex of the mandibular bone with the anterior cortex of the sliced chin fragment so that a stronger stabilization effect ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 17
#17Prismatic scheme of the mandibular bone, the customized graft and the sliced chin fragment.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 18
#18The lines contour the fixation steel wires and the drilled holes to allow the assembly; at this stage all the elements were wired and ready to be secured.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 19
#19Once the wiring is deemed optimal and the assembly is ready, the surgeon pulls from the wiring to put all the parts together, which obtain stabilization by means of vertical vectors of compression, and stabilizes the assembly by tying steel ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 20
#20The chin fragment has been perfectly leveled thanks to the customized bone graft; note how the right end has larger thickness than the left end, designed in a progressive thickness increase from left to right.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 21
#21The lines contour the fixation steel wires and the drilled holes to allow the assembly; at this stage all the elements were wired and ready to be secured.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 22
#22Once the wiring is deemed optimal and the assembly is ready, the surgeon pulls from the wiring to put all the parts together, which obtain stabilization by means of vertical vectors of compression, and stabilizes the assembly by tying steel ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 23
#23The chin fragment has been perfectly leveled thanks to the customized bone graft; note how the right end has larger thickness than the left end, designed in a progressive thickness increase from left to right.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 24
#24The lines contour the fixation steel wires and the drilled holes to allow the assembly; at this stage all the elements were wired and secured.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 25
#25Once the wiring is deemed optimal and the assembly is ready, the surgeon pulls from the wiring to put all the parts together, which obtain stabilization by means of vertical vectors of compression, and stabilizes the assembly by tying steel ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 26
#26The chin fragment has been perfectly leveled thanks to the customized bone graft; note how the right end has larger thickness than the left end, designed in a progressive thickness increase from left to right.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 27
#27The lines contour the fixation steel wires and the drilled holes to allow the assembly; at this stage all the elements were wired and secured.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 28
#28Before and after comparison. The chin is perfectly leveled and balanced; vertical increase was accomplished as per planned parameters.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 29
#29Before and after comparison. The chin is perfectly balanced; forwarding and vertical increase were accomplished as per planned parameters.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 30
#30Before and after comparison. The chin is perfectly leveled and balanced; vertical increase was accomplished as per planned parameters.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 31
#31Before and after comparison. The chin is perfectly balanced; forwarding and vertical increase were accomplished as per planned parameters.
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 32
#32A control lateral X ray taken 1 month later shows excellent osseous and osteotomy positioning; later on there will be full ossification of the assembly; note how the steel wiring is buried within the bone callus and the knots are not a problem ...Read more
Small chin,Weak chin,Elbow bone graft harvesting,Oblique chin osteotomy,Osseous chin advancement,Two dimensional genioplasty,Vertical osseous chin grafting - photo 33
#33Orthopantomography showing perfect placement, leveling and stability of the assembly.

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