Applying Machine Learning to Determine Popular Patient Questions About Mentoplasty on Social Media.

PURPOSE: Patient satisfaction in esthetic surgery often necessitates synergy between patient and physician goals. The authors aim to characterize patient questions before and after mentoplasty to reflect the patient perspective and enhance the physician-patient relationship. METHODS: Mentoplasty reviews were gathered from Realself.com using an automated web crawler. Questions were defined as preoperative or postoperative. Each question was reviewed and characterized by the authors into general categories to best reflect the overall theme of the question. A machine learning approach was utilized to create a list of the most common patient questions, asked both preoperatively and postoperatively. RESULTS: A total of 2,012 questions were collected. Of these, 1,708 (84.9%) and 304 (15.1%) preoperative and postoperative questions, respectively. The primary category for patients preoperatively was "eligibility for surgery" (86.3%), followed by "surgical techniques and logistics" (5.4%) and "cost" (5.4%). Of the postoperative questions, the most common questions were about "options to revise surgery" (44.1%), "symptoms after surgery" (27.0%), and "appearance" (26.3%). Our machine learning approach generated the 10 most common pre- and postoperative questions about mentoplasty. The majority of preoperative questions dealt with potential surgical indications, while most postoperative questions principally addressed appearance. CONCLUSIONS: The majority of mentoplasty patient questions were preoperative and asked about eligibility of surgery. Our study also found a significant proportion of postoperative questions inquired about revision, suggesting a small but nontrivial subset of patients highly dissatisfied with their results. Our 10 most common preoperative and postoperative question handout can help better inform physicians about the patient perspective on mentoplasty throughout their surgical course. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Basal Extended Mentoplasty.

Introduction: The chin is one of the most visible facial structures. Chin surgery, was initially described, for, the treatment of facial abnormalities, advancing the mandibular symphysis; achieved anterior displacement of the base of the tongue showing some value in the treatment of snoring and obstructive sleep apnea, and achieved adequate lip competence. We designed the Basal Extended Mentoplasty (BEM) based on the needs of patients orthodontically compensated, but dissatisfied with the appearance of his face as well as upper airway problems looking for a solution to this, design and planning the advances of the chin. Materials and Methods: Patients operated in the service of Maxillofacial Surgery, Specialist Hospital, "Dr. Bernardo Sepulveda "XXI Century National Medical Center, during the period of 2015-2019, orthodontically compensated patients, with labial incompetence and Class II skeletal. Sixty-five patients were operated during this period, and eight cases are presented. Results: Lip competition, osseointegration of the segments is observed, with a proper projection of the lower third, no nerve or vascular damage in the area. Conclusions: The design of the osteotomy is for orthodontically compensated patients with labial incompetence and Class II skeletal, giving a result mandibular lengthening. The BEM achieved adequate lip competence demonstrated by an interlabial gap of 0 mm, achieved adequate osseous consolidation of the fracture site with a more harmonious facial balance and profile, without nerve or vascular damage with spectacular results.

Reduction genioplasty for mandibular prognathism and long chin.

BACKGROUND: When evaluating patients' profile, surgeons usually note the lack of the chin projection and may suggest chin augmentation, but they rarely discuss reduction of an over-projecting chin. This is unfortunate, since there are quite many individuals who have macrogenia and would aesthetically benefit from corrective surgery, but the chin reduction is seldom offered. The reason for this is the lack of experience, lack of the technical equipment necessary, or sometimes lack of knowledge. The present study conveys 25 years of experience with the reduction genioplasty. METHODS: From 1994 to 2019, 47 patients (39 females, 6 males, and 2 male to female transsexuals) underwent 49 chin reduction procedures. All patients were operated and followed up by the author. The transoral approach was used in 23 patients, and in 24 patients the procedure was done through the straight 4- to 6-cm-long submental incision. The air-driven pneumatic chisel was employed for reduction of the mandibular bone (MicroAire, Charlottesville, VA, USA). Forty-eight operations were carried out under dissociative and local anaesthesia on an outpatient basis, and one procedure was done under general endotracheal anaesthesia. RESULTS: Both mandibular bone and the soft tissues of the chin were reduced, or modulated according to the needs of each patient. Operations were technically easier when executed by the submental approach because of better exposure of the mandibular rim and the higher precision in the remodelling of the soft tissues. Thirty-six patients (77%) could be followed up for a mean of 2.5 years (range 9 months to 12 years). Twenty-eight of evaluated patients (78%) described the outcome as very good or good. Four patients described the result as acceptable and another 4 as bad. In the majority of cases the evaluation by the surgeon correlated well with the opinion of patients, but in five cases surgeon estimated result with the higher score than the patient. Overall good results were illustrated by the photographs of the clinical examples. Complications were few and manageable. Transient neuropathies were common and more frequent with the transoral approach. Five patients required minor intervention for skin indentations at the jaw line developed during the healing phase. CONCLUSIONS: Skilful chin reduction surgery is safe and the aesthetic improvement could be quite spectacular, which is also rewarding for the patients. Complications in this patient series were few and manageable. More surgeons should include chin reduction in their repertoire.

Advantages of performing mentoplasties with customized guides and plates generated with 3D planning and printing. Results from a series of 23 cases.

PURPOSE: To evaluate the benefits of performing mentoplasty using custom guides and plates in a series of 23 patients. PATIENTS AND METHODS: An 18-month observational study in 23 patients (16 women, 7 men) who underwent procedures for chin augmentation (n = 15), reduction and centering mentoplasty (n = 6), chin asymmetry correction (n = 1) and placement of a custom chin implant to correct esthetics (n = 1) was conducted in the Department of Oral and Maxillofacial Surgery of Hospital Universitario Dexeus (Barcelona, Spain). RESULTS: A mentoplasty technique using customized surgical guides and plates, performed under local anesthesia and oral sedation, was performed in every case. Surgery times were approximately 45 min. Postoperative recovery was satisfactory in all patients. There were no intraoperative or serious postoperative complications, except for one self-limiting edema and some small hematomas of no clinical significance. Post-operative pain intensity measured by the Visual Analog Scale (VAS) was less than 3 (mild pain) in 80% and 4-7 (moderate pain) in 20% of patients. CONCLUSION: The results obtained in this study show that using customized surgical guides and plates in performing mentoplasty is an advantage over conventional techniques as they provide greater accuracy and safety in the surgery and more predictable results. This simplifies the procedure.

Changes in the airway after mentoplasty (genioplasty): systematic review / Cambios en la vía aérea después de una mentoplastia (genioplastia): una revisión sistemática

SUMMARY: The aim of this research was to evaluate the changes obtained with the mentoplasty technique in the increase of the airway imaging. A systemic review was performed using the parameters of the prism matrix, in the PubMed, Science Direct, Redalyc database, covering the years 1984 to 2019 with the use of defined inclusion criteria. The authors independently applied the selected parameter of data extraction, study selection and risk-to-bias assessment. A total of 1,251 articles were obtained among the 3 databases, of which 10 met the inclusion criteria. The variables studied were: type of research, sample size, sex, age, dento-skeletal diagnosis, airway classification, diagnosis of obstructive sleep apnea syndrome (OSAS), type of imaging evaluation, variables evaluated in the image, pre and post-operative values, surgical technique and type of fixation used, other surgical procedures applied, and complications. In the cases of linear evaluation with cephalometric analysis (9 articles) they used PAS (posterior airspace), MP-H (mandibular plane to the hyoid) and SNB (saddle-nasion-point B), and SCSA (section area as the most relevant points, smallest cross section) and VT (total volume) in the volumetric evaluations (2 articles). The average change in posterior airspace achieved by the cited authors is 4.2 mm with standard deviation of 1.4 mm with the use of advancement mentoplasty. The most widely used technique was mentoplasty with a horizontal osteotomy by 5 authors. Based on the research there is a positive relationship between the increase in the airway and the advancement mentoplasty procedure, however, more standardized studies associated with the way of measuring and evaluating the relationship between advancement and the airway are necessary.

RESUMEN: El objetivo de esta investigación fue evaluar los cambios obtenidos con la técnica de mentoplastia en el incremento de la via aérea. Una revisión sistemática fue realizada utilizando parámetros de la matriz prisma, en PubMed, Science Direct, Redalyc database, cubriendo los años 1984 a 2019 con criterios de inclusión definidos. Los autores aplicaron de forma independiente los parámetros de selección y extracción de datos, selección de estudios y riesgos de sesgo. Un total de 1251 artículos fueron obtenidos de las 3 bases de dato, donde 10 artículos cumplieron los criterios de inclusión. Las variables estudiadas fueron: tipo de investigación, tamaño de la muestra, genero, edad, diagnóstico dento esqueletal, clasificación de la vía aérea, diagnostico de síndrome de apnea del sueño (SAOS), tipo de evaluación de la imagen, variables evaluadas en la imagen en pre y postoperatorio, técnica quirúrgica y tipo de fijación utilizada, otros procedimientos quirúrgicos y complicaciones. En el caso de la evaluación linear con cefalometria (9 artículos), usaron PAS (posterior airspace), MP-H (plano mandibular hacia el hueso hioide) y SNB (silla turca-nasion- punto B) y SCSA (sección de puntos mas relevantes, menores transfversales) y el VT (volumen total) en las evaluaciones volumétricas (2 artículos). El promedio de cambio posterior de la vía aérea citado por autores fue de 4,2 mm con una desviación estándar de 1,4 mm con el uso de la mentoplastia de avance. La técnica mas habitual fue la mentoplastia con osteotomía horizontal (5 autores). Basados en esta investigación existe una relación positiva entre el incremento de la vía aérea y el avance con genioplastia; sin embargo, mas estudios estandarizados junto con medidas definidas y la evaluación correcta del avance y la vía área son necesarios.

Chin Advancement, Augmentation, and Reduction as Adjuncts to Rhinoplasty.

Chin deformities are commonly encountered defects in patients seeking rhinoplasty. Careful preoperative evaluation may identify patients who could benefit from concurrent augmentation or reduction mentoplasty. Alloplastic chin implants and sliding genioplasty represent the main accepted methods of chin augmentation. Although both procedures may be used for retrognathia or microgenia, the sliding genioplasty may also be used in chin asymmetry, prognathia, and vertical height discrepancies. This article outlines the methods to analyze the chin, and discusses the treatment options available for correction of chin deformities as an adjunct to rhinoplasty.

Aumento mentoniano com retalho cervical associado à ritidoplastia / Chin augmentation with cervical flaps associated with rhytidoplasty

Introdução: A falta da projeção mentoniana no terço inferior da face algumas vezes é responsável pela quebra da harmonia do contorno facial. A utilização de implantes aloplásticos, preenchimentos submetidos à ritidoplastia para correção destas deformidades. Neste estudo, propomos uma nova manobra para aumento da projeção mentoniana com uso de um retalho cervical associado à ritidoplastia. Métodos: Foram avaliados 11 pacientes operados no período de 01/2017 a 01/2018, utilizando-se o retalho cervical para projeção mentoniana, e tendo como critério de inclusão somente pacientes que almejavam um aumento mentoniano, sem utilização de próteses, preenchimentos ou abordagem óssea, e que seriam submetidos à ritidoplastia. Resultados: Através da análise cefalométrica evidenciou-se melhora da projeção mentoniana e do contorno cervical, e não houve complicações no pós-operatório imediato ou tardio. Conclusão: O retalho cervical utilizado para aumento mentoniano além de apresentar resultados e aceitação satisfatórios, elimina o uso de materiais sintéticos, redução de custos, segurança e durabilidade, alcançando um contorno mandibular mais refinado e uma projeção mentoniana mais natural.

Introduction: The lack of chin projection in the lower third of the face is sometimes responsible for the breaking of the facial contour harmony. Alloplastic implants, fillers, and osseous advancements have been used to correct these deformities. In this study, we propose a new maneuver to increase chin projection by using a cervical flap associated with rhytidoplasty. Methods: We assessed 11 patients who underwent operations using the cervical flap for chin projection between January 2017 and January 2018. The inclusion criteria were only patients who desired chin augmentation without the use of prosthetics, fillers, or osseous approaches, and those who would undergo rhytidoplasty. Results: A cephalometric analysis revealed improvements in chin projection and cervical contour, and no complications in the immediate or late postoperative period. Conclusion: In addition to presenting satisfactory results and acceptance, the cervical flap used for chin augmentation eliminated the use of synthetic materials, reduced surgical costs, and improved safety and durability, achieving a more refined mandibular contour and natural chin projection.

Effect of mentoplasty on esthetic perception of dental surgeons, dental students and lay persons / Efeito da mentoplastia na percepção estética de cirurgiões-dentistas, estudantes de odontologia e leigos

Objective: was to evaluate the influence of mentoplasty on esthetic perception of dental surgeons, dental students and lay persons. In addition, to determine whether the outstanding chin affects the perceived desire for orthognathic surgery. Material and Methods: An image of an ideal silhouette was created. This image was manipulated to create another six images with different degrees of retrogenia and progenia in increments, advancing and receding the chin on a scale of 5 mm (from +15 to -15 mm) in the anteroposterior and vertical directions. Once the images were obtained, a questionnaire was created, which was evaluated by lay persons, dental surgeons and dental students (n = 50). The evaluators used a visual analog scale to analyze the images, establishing a score ranging from 0 to 10. Associated with the scale, the evaluators were asked whether they wished to have some surgical correction performed if the image in question were a representation of their own facial profile. Results: demonstrated that image H (0 mm) was ranked as the most attractive by the dental surgeons, while the dental students and lay persons scored B (-5 mm) as the best image. In general, images A (+15 mm) and D (-15 mm) were those that most induced a desire for corrective surgery. Conclusion: the prognathic and retrognathic facial profiles were unpleasant and perceptible to the dentist, dental student and lay person. The more projected and retracted the chin was, the greater was the desire to have orthognathic surgery performed. (AU)

Objetivo: avaliar a influência da mentoplastia na percepção estética de cirurgiões-dentistas, estudantes de Odontologia e leigos. Além de determinar se o destaque do mento afeta o desejo percebido ORIGINAL ARTICLE Effect of mentoplasty on esthetic perception of dental surgeons, dental students and lay persons Efeito da mentoplastia na percepção estética de cirurgiões-dentistas, estudantes de odontologia e leigos Matheus Melo PITHON1 , Diego Oliveira GUEDES1 , Solane Domingues LEAL1 ,Maria Luiza Anselmo da SILVA1 , Raphaela Rodrigues DANTAS1 , Ketlly Cruz da Cunha PELEGRINI1 , Raildo da Silva COQUEIRO2 1 - Southwest Bahia State University ( UESB) - Vitória da Conquista ­ BA - Brazil. 2 - Federal University of Santa Catarina (UFSC) - Florianópolis ­ SC - Brazil. doi: 10.14295/bds.2019.v22i2.1687 UNIVERSIDADE ESTADUAL PAULISTA "JÚLIO DE MESQUITA FILHO" Instituto de Ciência e Tecnologia Campus de São José dos Campos Ciência Odontológica Brasileira por cirurgia ortognática. Material e Métodos: a imagem de uma silhueta ideal foi manipulada para criar outras seis imagens com diferentes graus de retrogenia e progenia em incrementos, avançando e recuando o mento numa escala de 5 mm (de +15 a -15 mm) nos sentidos ântero-posterior e vertical. De posse dessas imagens criou-se um questionario que foi avaliado por leigos, Cirurgiões-Dentistas e estudantes de Odontologia (n = 50). Os avaliados utilizaram uma escala visual analógica para analisar as imagens, estabelecendo nota que variam de 0 a 10. Associado a escala os avaliadores foram questionados se eles teriam vontade de realizar alguma correção cirúrgica caso aquela imagem representasse o seu próprio perfil facial. Resultados: demostraram que a imagem H (0 mm) foi ranqueada como a mais atratativa pelos cirurgiões dentistas, enquanto os estudantes de odontologia e pessoas leigas pontuaram a B (-5 mm) como a melhor. De forma geral, as imagens A (+15 mm) e D (-15 mm) foram as que mais induziram o desejo por cirurgia corretiva. Conclusão: o perfil facial prognata e retrognata é desagradável e perceptível para o dentista, o estudante de odontologia e o leigo. Quanto mais projetado e retruido for o mento maior o desejo pela realização de cirurgia ortognática. (AU)

Reabsorção óssea associada ao implante de silicone em mentoplastia: relato de caso clínico / Bone reabsorption associated with silicone implants in mentoplasty: a clinical case report

Durante muitos anos, os implantes de silicone foram utilizados em cirurgias reconstrutivas e estéticas, principalmente em casos em que o perfil facial do paciente apresenta deficiência no terço inferior da face. Este material tem provado ser bem sucedido na maioria dos aspectos, contudo, algumas complicações já foram bem relatadas na literatura, como é o caso das reabsorções ósseas na região de mento mandibular. No presente artigo os autores apresentam dois casos clínicos de reabsorção óssea da cortical anterior do mento, associada ao implante de silicone e discutem a etiologia, as complicações e o plano de tratamento.

For many years, silicone implants were used in reconstructive and esthetic surgeries, especially in cases in which the facial profile of patients presented deficiencies in the inferior third of the face. This material proved to be successful in most aspects. However, several complications were well reported in the literature, as the case of bone reabsorption in the region of the mandibular chin. In this article, the authors present two clinical cases of bone reabsorption from the anterior cortex of the chin associated with silicone implants and discuss the etiology, complications, and treatment plan.

Osseous genioplasty: A case series.

INTRODUCTION: The chin (mentum) is vital to the human facial morphology as it contributes to the facial aesthetics and harmony both on frontal and lateral views. Osseous genioplasty, the alteration of the chin through skeletal modification, can lead to significant enhancement of the overall facial profile. AIM AND STUDY DESIGN: A case series was designed to study the long-term results of osseous genioplasty in Indian patients with regard to patient satisfaction, complications, and long-term stability. MATERIALS AND METHODS: All subjects who underwent osseous genioplasty either alone or as a component of orthognathic surgery between January 1992 and December 2010, with a minimum follow-up of 2 years, were included. The genioplasty was performed using standard protocols of assessment and execution. Post-operative evaluation included patient satisfaction, complications and radiological evidence of long-term stability. A comprehensive score was formulated for the purpose of the study. RESULTS: Thirty-seven subjects underwent osseous genioplasty with at least 2 years of follow-up in the study period. This included 17 male and 20 female subjects, with a mean age of 22.8 years (15-52 years) and a mean follow-up of 3 years 4 months (2 years to 4 years and 11 months). Nineteen subjects underwent isolated genioplasty while 18 underwent genioplasty as a part of orthognathic surgery. The procedures included advancement (22), pushback (9), side-to-side (4) and vertical reduction (2) genioplasty. Thirty-six subjects (97.3%) were extremely pleased with the results with only one subject expressing reservations, without, however, demanding any further procedure. There were no significant complications. The osteotomised segment was well maintained in its new position with good bony union and minimal resorption. Overall, 35 (94.6%) cases had excellent results and 2 (4.4%) cases had good results, according to the comprehensive score. CONCLUSIONS: Osseous genioplasty is a safe and effective means of creating a beautiful and balanced facial profile by producing alterations in the chin morphology with minimal complications and excellent and stable long-term results.