Keeping hardware after genioplasty same as retainer requirement after braces?

[improvedchin]

Ok so I was advised by my orthodontist that I will need a retainer my whole life after completing my Invisalign treatment. I guess the reason behind this was that teeth could shift without some form of fixation, as the tissues have memory?

My question is, wouldn't we need some form of permanent life long fixation for our advanced and projected chins if we are to avoid relapse? (I was advanced around 7-8mm. No lengthening was done)

So why would we need something to keep the teeth stable even years after treatment, but still be able to keep our chin advancements without any permanent fixation?

Note: I understand the chin bones must fuse prior to plate removal, but I'm still wondering how the chin even keeps its advancement / projection without a plate when teeth need a retainer.

Looking forward to some responses on this. I've been stressing about having my plate removed but I'm freaking out over the possibility of a relapse. It's been 1.5 years after my second genioplasty.

[SJay]

Well, there's now bone in the gap. The chin has no place to go. That's not the case with the teeth, especially if you have extractions... I think the gums shrink a little but there's still excess room for them to move around. Can I ask why you're having the plates removed?

[improvedchin]

I feel mild pain on occasion. But my main concern is having a foreign body in my chin. So I'm guessing waiting longer before having the plate removed would help ensure larger quantities of bone fills in the gap, thereby further enforcing the chin's new placement / advancement, right?

[SJay]

Oh okay, well I suspect you're okay to remove it now if you're 1.5 years post op. My surgeon said the chin will be fully healed by one year. It's interesting that you had two, did you do this because you couldn't get enough advancement in a single surgery, how long did you wait between ops? I'm interested as I had 7mm about a month ago, but could ideally do with a few more mm.

[improvedchin]

Well I was told that I was advanced around 8mm from my first surgery, but the aesthetic changes appeared minimal. In fact, as the swelling went down, it became more apparent that I was hardly advanced. Note: this procedure was done with wires, not with a titanium plate.

I spoke to another surgeon around 3 months later and decided to proceed with a revision. He removed my wires and told me that there may have been a relapse.

Waited around 3 months in between surgeries, and am happy with results now. Initially, even after the revision, I felt I was a tad under projected, but as the swelling went down, I really started to appreciate my new appearance. If it helps, my chin was severely recessed prior to surgery, but 7mm was enough to produce an amazing improvement. Do you plan on having your plates removed and/or go in for a revision of any form?

[molestrip]

Once the bones heal there is no chance from chin to relapse. There are age related changes, facial decline, that happens to everyone. The reason surgeons leave the plates in is that every surgery carries risk and leaving the plates in is considered safer than taking them out. The plates aren't wonderful long term actually, they shield bone from stress so the union is good enough but not good as new. I would consider removal if it's causing you problems however.

As for foreign bodies, I sympathize there. It took me a while to accept them too. They look cool in pictures, I'm trying to remind myself of that. There is a lot of long term evidence on these things, they really do not cause problems for the most part. You might need small operations to remove various pieces of hardware with time. Surgeons use all kinds of other foreign bodies in surgery too, you probably don't even realize you have them.