Plastic surgery is one of the marvels of modern medicine, with a wide range of options for face and body improvements. And today’s media outlets make it easier than ever before to gather information on the latest plastic surgery procedures. But how does this information apply to you and your concerns?
Every person is unique and has his or her own desires. What procedure or combination of treatments is right for you? And what can you really expect? EXPLORE PLASTIC SURGERY with Dr. Barry Eppley, Indianapolis plastic surgeon, who can provide you with a wealth of practical and up-to-date insights into the world of plastic surgery through his regular blog posts. In his writings, Dr. Eppley covers diverse topics on facial and body contouring procedures. You will be sure to find useful information that will help broaden and enrich your plastic surgery education.
The location and prominence of the chin makes it a most visible facial part. It has a significant influence on the appearance and perception of one’s face. While it is recognized that a chin can be horizontally short or too long, and even vertically too short or too long, its position and shape is also impacted by its width. The transverse position and shape of the chin affects its perception of being midline or symmetric. An asymmetric chin is easily identifiable and can make the face look skewed or off center.
When the chin is asymmetric, the first step is to determine whether this is a result of an overall jaw asymmetry or whether it is restricted to just the chin. Some jaw problems are correctable and the chin will swing back to the midline when that is done. But while many chin asymmetries are due to one side of the jaw being shorter than the other, the patient may have no desire to undergo such corrective jaw surgery.
Chin asymmetry can be corrected through two basic approaches. Camouflage it with the placement of an implant on top of the bone or move the chin bone itself. (osteotomy) Either approach has its advantages and disadvantages.
While the use of an implant is simpler, it is more difficult to get good and accurate placement in some defects. Unlike a typical chin implant placement, the implant placement in chin asymmetry must be…..asymmetric. Either the implant must be placed in an asymmetric fashion or the implant itself must be shaped asymmetrically. That determination must be made intraoperatively and often involves a little bit of both. The modified chin implant must be secured into position with not one, but two screws, to ensure it does not move from its critical position. This works best when the chin has a transverse or frontal deficiency. While most chin implants are placed through a small incision underneath the chin, correction of chin asymmetries with implants should be done from inside the mouth where the entire shape of the chin can be bettered appreciated from above.
Many chin asymmetries, however, have both a transverse and vertical component to it. This particularly true when the chin asymmetry is significant or one side of the jaw is obviously different than the other side.This is when an osteotomy is preferable. The chin bone can be cut, slide over, and opened vertically (or a wedge taken and closed down if the asymmetry is because it is too long) and secured into this new position with small plates and screws. Bone grafts are rarely necessary as most chin gaps will fill in and heal on their own. Chin osteotomies are always done from an incision inside the mouth.
In more minor cases of chin asymmetry due to overgrowth, a simple reduction with a burr can be done. But this method requires that the soft tissue may need to be resuspended to avoid postoperative sagging. Also burring down is usually left effective than one usually thinks while doing it. For these reasons, I prefer an intraoral chin osteotomy and wedge removal to avoid these potential problems.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
Tags: chin, chin asymmetry, chin implant, chin osteotomy, dr barry eppley, indianapolis
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