PC53. Chin Dysmorphology in the Rhinoplasty Population: Incidence, Objective Analysis, & Implications

PURPOSE: Chin flaws are far more common than recognized. Discussing correction could pose a challenge with adolescent patients. Denial of genioplasty by parents or adult patients can present a surgical planning enigma. The true incidence of chin dysmorphology is not well-reported in this population, all of whom will be the subject of this study. METHODS: This review included 108 consecutive patients presenting for primary rhinoplasty. Demographics, soft tissue cephalometrics, and surgical details were obtained. Exclusion criteria included prior orthognathic surgery, mandible trauma, or congenital craniofacial deformities. RESULTS: Of the 108 patients, 16 (14.8%) were male and 92 (85.2%) female. Mean age was 30.8 years (range 14-72); 15 (13.9%) were younger than 18. All 108 (100%) patients exhibited some form of objective chin dysmorphology. Sixty-one (56.5%) demonstrated chin asymmetry (mean 3.9mm, range 1.3-8.1mm). Seventy-six (70.4%) had vertical microgenia (mean 7.2mm, range 1.5-18mm); 62 (57.4%) exhibited horizontal microgenia (mean 5.1mm, range 0.5-11.8). Ninety-eight (90.7%) demonstrated oral commissure canting (mean 2.1 degrees, range 0.5-5 degrees). Eighty-three females (90.2%) had a deepened labiomental groove (beyond 4mm). Five (4.6%) patients agreed to have simultaneous osseous genioplasty (mean advancement 7.8mm, range 5-9mm); 7 (6.5%) received fat grafting to the chin (mean volume 4.4cc, range 1-9cc). CONCLUSION: All primary rhinoplasty patients demonstrated quantifiable chin dysmorphology. Only a small proportion underwent genioplasty or fat grafting to improve facial harmony. This study supports a standardized analysis of chin morphology during consultation and an algorithmic approach to surgical correction. Potential reasons for patient aversion and mitigation strategies will be discussed.