Genioplasty is an often ignored option for patients who wish to add balance and harmony to their facial proportions. It is a great example of the importance of a detailed facial analysis in determining the surgical plan. A nose that seems too large, lips that don’t have an ideal shape, or even a lack of a well defined jaw line can all be caused by a chin that is just a bit too small. A small change in the size or position of the chin can result in a huge improvement in the overall appearance of the face. Genioplasty can be a useful addition to a rhinoplasty or neck lift.
The surgery is performed through a small incision hidden below the chin. A silicone implant can then be placed directly on the bone to add more projection to the chin. Pre-surgery analysis is critical to determine how much increase in chin size is necessary to achieve the desired result.
As the old song goes, “the toe bone is connected to the foot bone…” Facial aesthetics are highly interdependent. You might be dissatisfied with the size of your nose, or the shape of your jaw line, but the problem might originate from the chin. This is why the initial consultation and analysis is so important to identify the true causes of facial disharmony.
Who is a good candidate for a genioplasty:
Most patients who are in generally good health can be appropriate candidates for a genioplasty. During your consultation, Dr. Nagarkar will discuss with you in detail if he feels that a genioplasty is a good option for you.
How to prepare for surgery:
You must stop smoking or using any nicotine-containing patches or gums for 6 weeks before and after surgery. This is critical: smokers who undergo facial plastic surgery can have significant wound complications.
You should discuss with Dr. Nagarkar which medications and supplements you need to stop taking before surgery, and which ones you can continue. In general, blood-thinning medications such as Aspirin, Warfarin, Coumadin, Plavix, or Xarelto must be stopped for a few weeks before surgery. It is very important to provide complete information to prevent any post-operative problems. You will get detailed written instructions for pre- and post-operative care. In addition, you will receive any postoperative prescriptions you might need so that you can have them filled by your pharmacy in advance.
What to expect on the day of surgery:
Genioplasties require around 1 hour, but when combined with a rhinoplasty or face lift they will take longer. You should plan on having nothing to eat or drink after midnight the night before surgery. Generally, you will be able to go home immediately after surgery unless you had a face lift or other major procedure performed at the same time. You will need to have someone drive you to and from the surgery, and to help around the house for a few days while you get your energy back.
What to expect after surgery:
Results
Your surgery is designed and performed to achieve the best possible result and as close to 100% symmetry as possible on the operating table. In the first 48 hours after surgery, significant swelling occurs, and this is often asymmetric in nature. Swelling will resolve slowly over the course of a few weeks. The anesthetic medicines used in surgery can cause your lips to appear asymmetric for a few days after surgery – this is temporary.
The first few days
It is very important for the first several days after surgery that you keep your head elevated to prevent swelling. You should avoid anything that causes your heart rate to become elevated or your blood pressure to increase – so no strenuous activity. This is important, as an increased heart rate or blood pressure increases the risk of bleeding. Dr. Nagarkar will call you the day after you go home to check in with you and to answer any questions you might have.
Pain
Narcotic pain medications are usually needed only for a day or so, and often not needed at all. Anti-inflammatory over the counter medications like Tylenol are generally adequate. You should not use blood-thinning medications like Aspirin or Ibuprofen for pain, as these increase the risk of bleeding.
Incision care
Your incisions will be closed with external, non-dissolving sutures. However, you can start showering two days after surgery. You should avoid baths, swimming, jacuzzis, etc. for 3 weeks after surgery. It is critical that you protect your incisions from sun exposure as they are very sensitive to sunlight for the first six months of the healing process.
Drains
Unless you had a face lift at the same time, you should not require drains.
Diet
You can return to your regular diet after surgery, but for the first day or two, stick with lighter meals. Anesthesia can sometimes make your digestive system a bit sensitive, and having a double cheeseburger the evening after surgery is not recommended. It is very important to refrain from high-sodium foods because these will increase swelling and undo some of the improvement made by surgery
Work
Your swelling will be mostly resolved by about 2 weeks after surgery. Your sutures will also have been removed by this time, and you should be able to return to work.
Activities
You will be able to go back to non-strenuous activities such as walking, using a computer, writing, and so on, immediately after surgery.
Exercise
Aerobic exercise such as yoga, running, cycling, barre, etc., must be stopped for 3 weeks to allow the skin to heal and prevent bleeding complications. You should not lift anything over 10 lbs for the first 3 weeks.
Driving
You can resume driving once you are no longer taking narcotic medications, and when you feel that you are in full control of your car. This often takes a week or two.
Follow-up visits
You will see Dr. Nagarkar in the office usually around 7 days after surgery to remove sutures, and ensure that you are healing appropriately. We will see you again at the 2-3 week mark for a brief checkup, and then at 3 months, 6 months and 1 year after surgery.
To meet Dr. Nagarkar in person, schedule your consultation or call us.