Genioplasty with wires

[Bobbit]

I had been thinking about a very complicated SG and I still don't know if it's possible in one setting, it's a horizontal and vertical advancement of the chin bone and also has a cut made in the middle to spread them apart for a wider chin. All at once, is it possible for either methods and would the wiring technique be more suitable for this?
Appriciate the info.

"Three piece segmental sliding genioplasty"   or something like that is what I think you are describing.   I am pretty sure it can be done with standard plates and screws, specially designed plates and screws, or wires,  or even a combination.   

They split the chin and expand it horizontally.  Then take a piece of bone from a donor site and use the to fill the gap.  They can advance the whole arrangement, as needed.

[jawline]

I had been thinking about a very complicated SG and I still don't know if it's possible in one setting, it's a horizontal and vertical advancement of the chin bone and also has a cut made in the middle to spread them apart for a wider chin. All at once, is it possible for either methods and would the wiring technique be more suitable for this?
Appriciate the info.

You’re thinking of the T-shaped genioplasty, it’s where the cuts made to the bone form the shape of a T; the horizontal cut (to slide the bone forward and vertically lengthen it) then a vertical cut to the segmented piece (to widen the chin). It can be done in one operation using either wire fixation or plates and screws.

A grafting material (e.g. iliac bone) is placed between the cut segments for lengthening and widening the chin.

Here’s a picture of it (image A):



https://www.researchgate.net/figure/Intraoperative-view-of-T-shaped-genioplasty-A-Horizontal-widening-and-vertical_253330877


Also in regards to K wires, although not related to lengthening and widening, here’s an x-ray (left image) of wire fixation:



https://www.sylvainchamberland.com/en/ortho-101-en/surgery/

[jawline]

They don't modify the plate. They err on the side of 1mm too much or 1mm too little.

It seems that’s exactly what they do, either a mm more or less; I came across this from another site.

First surgeon:
“…he would not use plates and only secure the chin in its new position using just screws i.e. he would make the measurement himself and it allows him more flexibility and precision”

Second surgeon:
“…asked what increments do the plates come in, I was surprised to hear that they only come in increments of 2mm i.e. if 4mm turns out to be too much, you will end up with a 2mm plate ( Now, is SG really worth it for a 2mm increase?...I think not) Likewise if 4mm is not enough you will get a 6mm plate. (which might then cause a chin that sticks out beyond your bottom lip)”

http://messageboards.makemeheal.com/chin-jaw-implants/who-are-the-the-best-sliding-genioplasty-doctors-t162288-15.html

[fulcanelli]

I had a SG with plates and screws and I happy they didn’t use wires. Just feels like it will be more stable while you’re waiting for the tissue to grow into the gap. Also never felt any sensitivity and I am currently living somewhere really cold. Slightly disconcerting seeing all the hardware on an x ray though!