The sliding genioplasty is a commonly performed aesthetic facial procedure for those that prefer or need an autologous chin augmentation approach. There are numerous variations on how the chin bone is cut and moved for this operation but, in the end, they all need some method of bone fixation. Titanium plates and screws are the most common fixation method used to do so. When horizontal advancements are done a step plate is available that offers millimeter precision in the advancement as well as secure stability of the advanced bone segment.
While the fixation hardware is necessary for good bone healing, patients often inquire about whether the metal hardware needs to be removed and, if so, when could that done.
There is no compelling medical need to remove metal hardware in the chin providing it is ‘asymptomatic’. The chin is not a functionally load part of the lower jaw so there is no risk of stress shielding or hardware loosening. To the contrary bony overgrowth of part or all of the hardware is common. That being said there are several reasons why patients may consider removal. If the lower lip feels tight or tethered hardware removal is the go to maneuver suggested by surgeons…although this rarely provides relief since that is usually not the source of the problem. Palpability, temperature sensitivity and the personal need to get rid of a foreign body after it has served its purpose are uncommon reasons for doing so.
The chin bone heals very quickly so the metal hardware could be removed as soon as three months after the surgery. Most surgeons, however, recommend six months since there is no pressing need for the removal surgery.
Chin hardware removal surgery is far less traumatic than the original osteotomy procedure since the bone is not being cut. Variables amount of bone overgrowth will be seen on the step plate and over growth of the upper screw heads is to be expected. But the bone overgrowth its not usually very thick and can be successfully chipped off and the hardware removed. With hardware removal there will always be an imprint of it left on the bone. (which eventually partially or completely smooths over)
Dr. Barry Eppley
World-Renowned Plastic Surgeon