Anatomy and ideal proportion:
The height of the upper lip should correspond to a ratio of 1/3 and the height of the lower lip to a ratio of 2/3 of the total height between the base of the nose and the chin. The ideal mento-cervical angle is between 85° and 95°, this angle can open up if there is a retreat of the chin (retrogeny). A retrogeny can be corrected by bringing projection to the chin by different methods: hyaluronic acid injection, fat injection or siliconized prosthesis.
Technique:
Hyaluronic acid: point of entry (<1 mm under the chin), then filling: usually 2 to 3 ml are needed.
Lipofilling: fat removal (often inside the knee or abdomen) under local anesthesia (no pain with an adapted anesthesia), decantation and specific preparation of the fat (thus recovering a part of the purified fat, rich in stem cells) then reinjection by the same technique as the hyaluronic acid.
Silicone chin implant: local anesthesia, then 2.5 cm incision under the chin (hidden in the natural shadow areas). A custom-made prosthesis is inserted in contact with the bone in order to bring projection. The submental approach is preferred by Dr. Lucas, because compared to the intraoral approach, the postoperative period is easier for patients.
Results:
Time to results:
Hyaluronic acid: immediate
Lipofilling: 1 week
Prosthesis: 2-3 weeks
Longevity of results :
Hyaluronic acid: 9-18 months
Lipofilling and prosthesis: 5-10 years
Before procedure:
Stop smoking 1 month before lipofilling and prosthesis
Do not take Aspirin 10 days before surgery, inform Dr. Lucas of any anticoagulant medication (Sintrom, Coumadin, Eliquis, etc.) in order to arrange for its discontinuation or replacement.
Take Arnica capsules 5 times a day for 5 days before surgery to prevent hematoma.
Contra-indications hyaluronic acid: autoimmune diseases, pregnancy, breastfeeding
Contraindication silicone prosthesis: uncontrolled diabetes, active dental infection
Procedure :
Pain: pain during the procedure will be almost non-existent, with an adapted anesthesia
Duration of the procedure: 30 minutes for hyaluronic acid, 60 minutes for lipofilling or prosthesis
Anesthesia: local
Location: office for hyaluronic acid, operating room for lipofilling and prosthesis
Ambulatory (without hospitalization)
After procedure :
Post-operative pain: 1/10 often responding to Dafalgan
Social eviction:
Hyaluronic acid: no (discrete swelling during 24-48h)
Lipofilling and prosthesis: swelling and hematoma for 4-7 days
Suture removal: 7 days for the prosthesis
Return to work: immediate for hyaluronic acid, 2-3 days for lipofilling, 1 week for the prosthesis
Return to sports: 24 hours for hyaluronic acid, 10 days for lipofilling or prosthesis
Instructions:
Bed rest without major effort and ice mask for 2-3 days, as often as possible, to reduce swelling.
Do not compress the fat injection area if lipofilling (risk of fat loss)
Take Arnica capsules 5 times a day for 5 days after surgery to prevent hematoma
Stop smoking permanently to prevent fat and hyaluronic acid resorption
Hyaluronic acid:
Control Dr Lucas 2 weeks
Lipofilling and prosthesis
:
Dr. Lucas controls 2 days, 2 weeks, 3 months, 1 year.
Sun protection with an index higher than 50 during the 6 months following the surgery.
Follow-up of the scar after implant genioplasty by Dr. Lucas for 1 year after surgery is essential.
Complications:
– Infection, hematoma, asymmetry, under or overcorrection
– Intravascular emboli: it is important to have this procedure performed by a qualified physician who is accustomed to injecting this area, which is richly vascularized with a very variable vessel anatomy. A vascular embolism if it moves into the circulation of the retina can lead to blindness or necrosis.
– chin implant: infection, secondary implant displacement.
