The Transoral Chin Correction

Abstract

When I started my training in maxillofacial surgery, in very severe cases only did surgical correction of the chin anomaly seem to be indicated. In the retrogenia cases, a bone graft was onlayed via a submental approach. It often produced, temporarily, quite a pleasing enlargement of the chin prominence but at the expense of possible infection and a submental scar which could be rather unsightly. And, of course, also there was the disadvantage of a second operation at the donor site for the bone graft. But there was another great disadvantage. It was the amount of resorption of the bone graft which followed within a year. And it was not easy to shape it so that it would fit nicely against the chin surface and it was not easy to fix it either. Often enough the bone graft was just placed onto the cortical surface of the chin, with some cancellous bone placed around the contact area. The experience with these onlay grafts led me to formulate the principle: “Cortical bone shrinks like a mushroom in the sun, and cancellous bone melts away like ice cream when used as an onlay graft for contour correction ” (Principle Nr. 18).