Long-term skeletal and soft-tissue responses after advancement genioplasty

Introduction: The objectives of this cephalometric study were to assess the skeletal stability of advancement genioplasty 3 years after surgery and to evaluate the predictability of soft-tissue changes. Methods: The subjects comprised 21 consecutive patients who had no additional orthognathic surgical procedures. Lateral cephalograms were taken at 5 times: immediately preoperative, immediately postoperative, 6 months postoperative, and 1 and 3 years postoperative. Results: Mean surgical advancement at pogonion was 8.4 mm. Three years after surgery, mean relapse at pogonion was 8% of the surgical advancement. Part of this change was most likely due to bone remodeling. No patient demonstrated a clinically significant postoperative change at pogonion. The soft tissue of the chin was found to follow bony movement in a ratio of 0.9:1. Great individual variability was observed. The mentolabial fold depth increased as a result of the treatment. Effects of advancement genioplasty on the lips were small. Conclusions: A prediction ratio based on long-term skeletal changes is likely to generate an estimate that is more appropriate to present to the patient.