Is gap-defect really that important for BSSO/Genio?

[monecel]

When making the osteotomy either in BSSO or a sliding Genioplasty, as the movement advances bone and seperates part of it, there is a slight gap "defect". I want to advance my mandible by about 7-9mm and chin by about 8-10mm. Both of these movements could introduce a gap but the thing I'm thinking about is if the gap-defect really matters that much outside cases where the skin quality has degraded leading to less padding and more gap-defect show. I've seen many results of genio and BSSO without any noticeable problems, and while there are some solutions for the gap-defect (like titanium cover plates) is it even worth the extra effort and cost? Also there could be the potential downside of a rigid BSSO stability having more long-term issues (look up BSSO S-plate) so it's not all just clear upside. Would appreciate thoughts about this.

Reference:

S-Plate:

 

[monecel]

Also this

 

[LEFORT17]

When making the osteotomy either in BSSO or a sliding Genioplasty, as the movement advances bone and seperates part of it, there is a slight gap "defect". I want to advance my mandible by about 7-9mm and chin by about 8-10mm. Both of these movements could introduce a gap but the thing I'm thinking about is if the gap-defect really matters that much outside cases where the skin quality has degraded leading to less padding and more gap-defect show. I've seen many results of genio and BSSO without any noticeable problems, and while there are some solutions for the gap-defect (like titanium cover plates) is it even worth the extra effort and cost? Also there could be the potential downside of a rigid BSSO stability having more long-term issues (look up BSSO S-plate) so it's not all just clear upside. Would appreciate thoughts about this.

Reference:

View attachment 4381536

S-Plate:

View attachment 4381540

it really depends on the patient. seen some +15mm bsso's without any irregularities and 4-5mm with notches. im just praying it wont cuck me