title: Immediate osseous genioplasty with Kirschner wire fixation for revision of infected alloplastic chin implant.
abstract: Genioplasty is a useful tool for correction of congenital abnormalities, as well as for aesthetic improvements of the lower face. Both alloplastic implantation and osseous genioplasty techniques have long been used successfully to achieve satisfactory outcomes. However, alloplastic implantation can be associated with several known complications, including infection, bone resorption, and secondary soft tissue deformities. Typically, these issues arise in the early postoperative period, but there have been reported instances of late infectious complications and the associated sequelae. These cases are generally treated with removal of the implant and secondary revision at a later date. We present here the unique case of a 65-year-old woman who presented with an infected silicone chin implant 25 years after her initial surgery. In this case, we chose to perform an immediate osseous genioplasty at the time of implant removal to avoid the problems that can arise from unpredictable soft tissue healing, as well as an untoward aesthetic result from the significant bone resorption that had occurred in this patient. To minimize the presence of exposed hardware in this contaminated field, we used intraosseous Kirschner wire fixation for osteosynthesis of the advanced genial segment. Our patient experienced no complications from this procedure, the infection cleared, and a successful aesthetic outcome was achieved with this technique.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Louisiana State University School of Medicine, New Orleans, Louisiana 70112, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Stalder
authors.forename: Hugo
authors.initials: H
authors.lastname: St Hilaire
mesh_terms: D000368:Aged; D001864:Bone Wires; D002680:Chin / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D020878:Device Removal; D005260:Female; D063172:Genioplasty / Q000379:methods*; D006801:Humans; D019736:Prostheses and Implants; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed